“Bringing Actual Facts To Bear”: The Truth Is, Obamacare Is Working
The Obamacare website might still not be working, but journalists are. All across the country, as Republicans try to highlight tragic tales of Americans losing their current health insurance and allegedly stuck with more expensive options, journalists are coming to the rescue. In case after case, journalists investigated these stories and called the policyholders and combed the insurance exchange websites to bring actual facts to bear in our public debate about Obamacare.
Here are just some of the mythical stories journalists have helped dispel — and the lessons we can learn from them about the reality of the Affordable Care Act:
Deborah Cavallaro was making the rounds on television complaining about how her current insurance plan was canceled under Obamacare. So Los Angeles Times columnist Michael Hiltzik talked to her. Her current plan cost $293 per month but had a deductible of $5,000 per year and out-of-pocket annual limits of $8,500. Also, the current plan covered just two doctor’s visits per year.
But in the California insurance exchange, which Hiltzik helped Cavallaro check, she could get a “silver” plan for $333 per month — $40 more than she’s currently paying. But the new plan has only a $2,000 deductible and maximum out-of-pocket expenses at $6,350. Plus all doctor visits would be covered. Hiltzik writes, “Is that better than her current plan? Yes, by a mile.”
Dianne Barrette also popped up on television on a CBS news report in which she lamented that her $54-per-month insurance plan had been canceled under Obamacare. But Nancy Metcalf at Consumer Reports investigated Barrette’s story and found that her current policy was a “textbook example of a junk plan that isn’t real health insurance at all.” According to Metcalf, if Barrette had ever tried to use her insurance for anything more than a sporadic doctor’s visit, “she would have ended up with tens or hundreds of thousands of dollars of medical debt.”
The plan, for instance, only pays for hospitalization in cases of “complications of pregnancy.” Instead, Metcalf found that Barrette could get a “silver” plan in the state insurance exchange for $165 per month that would actually cover Barrette in the case of any sort of serious or even moderate illness. Which is the very definition of insurance, isn’t it?
Edie Littlefield Sundby, a stage-four gallbladder cancer survivor, published an op-ed in the Wall Street Journal blaming the Affordable Care Act for her canceled insurance policy. In her essay, Littlefield wrote that because of Obamacare, “I have been forced to give up a world-class health plan.” But, according to Igor Volsky of Think Progress, Sundby’s insurer, United Healthcare, “dropped her coverage because they’ve struggled to compete in California’s individual health care market for years and didn’t want to pay for sicker patients like Sundby.”
Earlier this year, United, which has publicly supported the Affordable Care Act, announced that it would pull out of the individual market in California. A company representative said it withdrew because its individual plans have never had a huge presence in the state. According to United, and in compliance with state law, the company won’t be able to re-enter the California individual market until 2017.
By then though, competitors will get stuck with sicker patients like Sundby signing up in the first wave of Obamacare. This means that companies like United can cover cheaper patients if it decides to go back to the California individual insurance market.
According to a report by Dylan Scott at Talking Points Memo, a Seattle woman named Donna received a cancellation letter from her insurance company regarding her current plan. The letter steered Donna and her family into a more expensive option and said, “If you’re happy with this plan, do nothing.” The letter made no mention of the Washington State insurance exchange, where Donna could find plenty of other more affordable choices, because the company wanted a convenient excuse to jack up Donna’s rates.
Had Donna “done nothing,” she would have ended up spending about $1,000 more per month on insurance than the cost of insurance she ultimately chose through the Obamacare exchange. In fact, the practice of trying to mislead customers has become so widespread that Washington state regulators issued a consumer alert to customers.
This is just the tip of the iceberg. Republicans who have been desperate from the very beginning to destroy Obamacare at any cost, regardless of facts or the urgent health care crisis facing America, will continue to dig up stories of people supposedly harmed by the law. And journalists will hopefully continue to investigate these allegations, helping us all sort fact from fiction.
In the meantime, there’s a side benefit to all this: If you are one of the small fraction of Americans who currently relies on the individual insurance market and has seen your current policy canceled, call a journalist — like one of those in the stories above. Reporters all across the country are hungry for real-life stories about how Obamacare is working.
Plus, most reporters have access to high-speed Internet. If you can’t get through to the Obamacare exchange site, there’s a journalist standing by willing to help you navigate the exchange options and explore your pros and cons in terms of costs and benefits. The website might still be glitchy, but old-fashioned shoe-leather reporting is as reliable as ever.
By: Sally Kohn, Special To CNN, November 8, 2013
“Very Well-Insured Critics”: Serving The Smug, Shortsighted, Dopes And Demagogues, Obamacare Will Be There Even For Its Enemies
Obamacare’s enemies are right about the disastrous Web site launch and the president’s misleading mantra about “keeping your plan.” I’m furious at the White House myself for having botched these technical and messaging challenges — issues that anyone could have seen coming three years ago and whose amateur handling has given needless ammunition to the foes of expanded health coverage.
But for those of us who think the health security the Affordable Care Act provides marks a fundamental advance in America’s social contract, these White House failures don’t come close to the vices of Obamacare’s adversaries. Let’s just say it: To judge by their behavior, the Affordable Care Act’s enemies couldn’t care less about helping millions of low-income workers achieve health security, and every time they open their mouths, it shows.
When conservatives rant about the latest mess-ups attending the rollout, they never add the obvious empathetic refrain. It would be simple, really. They’d just need to preface or append to their daily attack a line like this: “Of course we all agree we need to find ways to get poor workers secure health coverage that protects their family from ruin in the event of serious illness.”
That’s all it would take. But they don’t say that. None of them. At least none that I can hear. A single omission might seem an oversight. A few might be a sign of distraction. But when day after day you wait in vain to hear such empathy amid the torrent of anti-Obamacare venom being spewed, you realize something bigger psychologically is at work.
Obamacare foes are more than just angry with the “lying” and the bungling they disdain. They are Very Well-Insured People. We all know about “VIPs.” Well, these are VWIPs. Or at least, a certain conservative species of VWIP.
For many on the right, being a VWIP seems to bring with it a certain blindness. They see the Web site comedy of errors and cry (rightly) “incompetence!” They see some people who have to change their health plan and cry (with some fairness) “liar!”
But that’s all they see. What they don’t see is nearly 50 million uninsured Americans, 20 million or so of whom stand to have relatively desperate lives made immeasurably more secure thanks to this law. These Americans will finally know what it’s like to go to bed at night certain that they can’t be wiped out financially by illness — and that free or affordable preventive care may help their loved ones uncover disease while there’s a chance for a cure.
Obamacare’s well-insured critics don’t see these Americans at all. And they seem unable to imagine what it would feel like to be one of them.
I want to be careful here. I know this isn’t the outlook of every Republican or conservative. John Kasich’s Medicaid expansion makes him the most prominent exception (though even Kasich can’t see the benefit for many Ohioans of Obamacare’s big private insurance expansion). Meanwhile, in yet another case in which your zip code seals your fate in the United States, millions of citizens who could have had Medicaid coverage will remain vulnerable, abandoned by well-insured GOP governors who think their job involves tending to well-insured GOP voters.
Poor uninsured workers didn’t make U.S. health care the costliest, most inefficient system on the planet. But these workers are the ones who suffer most under it. And VWIPs on the right don’t care.
New rule (as Bill Maher would say): Politicians and pundits who bash Obamacare should have displayed under their talking head or byline the source of their own coverage. Let’s caption Ted Cruz in flashing neon that reads, “Enjoys Gold-Plated Health Coverage from Goldman Sachs Spousal Plan.” Let’s have the subtitles for John Boehner and Eric Cantor read, “Has Never Worried About Going Broke From Illness A Day in His Life Thanks To Federal Government Insurance.”
And let Obamacare supporters begin their response to absurd claims that “Obamacare is the enemy” with this simple line: “Spoken like a Very Well-Insured Person.” (I’ve tried this on radio and TV — not only is it accurate, but it feels great to say so, too.)
My wife and I discovered we were uninsurable in the individual market in 2003. It was scary. And we’re the lucky ones — bona fide members of the Lower Upper Class with the wherewithal to maneuver to protect our family (and with access to the New York Times Magazine to write about the experience).
Obama said, “If you like your plan, you can keep it.”
The Very Well-Insured Obamacare critic effectively says to the uninsured, “If you enjoy being vulnerable to financial ruin or death from serious illness, under our plan you can keep that, too.”
Both of these positions are wrong.
But which, at the end of the day, seems more like a hanging offense?
The irony is that Obamacare’s protections will be there even for its enemies if, God forbid, they (or someone they love) find themselves sick, unattached to a large employer and looking for coverage in the individual market. I suppose that’s the beauty of the rule of law — it serves the smug and the shortsighted, the dopes and the demagogues along with the rest of us. Might be a more just world if it didn’t now and then, but them’s the breaks.
By: Matt Miller, Opinion Writer, The Washington Post, November 6, 2013
“Far-Reaching Consequences”: Obamacare, Mental Illness, And Guns
After years of delays, the Obama administration has released final regs aimed at implementing 2008 legislation requiring “parity” in insurance coverage of mental illness, as Jackie Calmes and Robert Pear of the New York Times report today:
The rules, which will apply to almost all forms of insurance, will have far-reaching consequences for many Americans. In the White House, the regulations are also seen as critical to President Obama’s program for curbing gun violence by addressing an issue on which there is bipartisan agreement: Making treatment more available to those with mental illness could reduce killings, including mass murders.
Remember gun violence?
In issuing the regulations, senior officials said, the administration will have acted on all 23 executive actions that the president and Vice President Joseph R. Biden Jr. announced early this year to reduce gun crimes after the Newtown, Conn., school massacre. In planning those actions, the administration anticipated that gun control legislation would fail in Congress as pressure from the gun lobby proved longer-lasting than the national trauma over the killings of first graders and their caretakers last Dec. 14.
But there’s another big piece of the puzzle that is necessary to make sure mental health benefits are available to the people most at risk of committing acts of violence: the Affordable Care Act. As Harold Pollack explained in a major article in the March/April 2013 issue of the Washington Monthly, the ACA’s Medicaid expansion alone is a really big deal for people with mental illness and/or addictions who are prone to violence:
Why do so many people at risk—many of them young low-income men—fail to receive appropriate mental health services? The most important single reason is this: most are categorically ineligible for Medicaid. These men are not custodial parents. They are not veterans. They have not (yet) been diagnosed with federally recognized disabilities. Many get into trouble because they have serious drug or alcohol disorders. Since 1996, substance use disorders are no longer qualifying conditions for federal disability programs….
This will begin to change in 2014. That’s when the ACA will start providing subsidies that will eventually reach thirty-three million Americans without health insurance. An estimated sixteen million will eventually be covered by expanded Medicaid to low-income Americans with incomes below 138 percent of the federal poverty line. That number will include the hundreds of thousands of mentally ill men cycling in and out of places like Chicago’s Cook County Jail and sleeping on grates in cities from Washington, D.C., to Seattle. For the first time, nearly all of these individuals (undocumented immigrants are the big exception) will gain access to regular health care. Moreover, if the law is properly implemented, these same individuals will gain access to mental health services that can reduce their propensity to commit violent acts.
So if you want some very good news about the impact of Obamacare, and some very bad consequences if it fails to be fully implemented, there you are.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, November 8, 2013
“What Really Matters”: Don’t Knock Obamacare Until You Try It
There has been a steady drumbeat of news stories about health insurance companies informing customers that their policies will be dropped or that they will face steep rate increases due to requirements of the Affordable Care Act.
This has opened the door to fair criticisms that President Obama wrongly stated that people would be able to keep their current insurance policies if they are happy with them, as this isn’t necessarily the case. However, the real question for individuals facing rate hikes or dropped coverage is whether there are insurance options provided through the exchanges, mandated by the new law, that these people would actual prefer, thanks to some combination of lower prices and more generous benefits. Obamacare might cause some to lose their current policy, but it also might provide them with options they would prefer. That is what really matters.
People should remember that the program provides subsidies for lower income individuals and families. At least in states that have accepted the very generous federal contribution, Obamacare also expands access to Medicaid. For many people who currently lack insurance, a group of people who tend to be poorer, Obamacare insurance policies will be free or relatively cheap.
The initial implementation of Obamacare has not gone smoothly. The key problem is website difficulties faced by people who are attempting to see just how much a plan will cost them, and whose attempts to actually sign up for a policy have been thwarted. We will see if these problems are fixed in a timely fashion, and whether other serious problems crop up.
But the program, as designed, is intended to lower prices for the vast majority of people on the individual insurance market, as well as to open it up to people who previously have been denied affordable coverage because of pre-existing medical conditions. Optimistically, increased competition could even lower prices for employer-based health plans.
Admittedly, such optimistic predictions might not come to pass. Over the next several months we will get a better idea of how many people manage to enroll, whether their coverage is adequate, and whether their overall medical costs, including premiums and out of pocket costs, fall. We might ultimately declare Obamacare a failure, and if that happens we should figure out a better way to expand access to affordable health insurance and care.
Despite the rhetoric from many conservatives, Obamacare isn’t the way most self-described liberals would reform our health care system. It is needlessly complicated, not guaranteed to reduce overall medical costs significantly and its subsidies, while significant, are too stingy. People with lower middle class incomes will still likely find the premiums to be a budgetary strain. At the very least, liberals would have included a government run “public option,” a Medicare-like program that would have competed with the private insurance.
But problems aside, people who are currently navigating the private insurance market –both those without health insurance currently and those who might be receiving scary policy and price change letters from their current insurance companies — should make sure to see just what their Obamacare options are. They might be pleasantly surprised.
By: Duncan Black, USA Today, November 5, 2013
“This Is Why We Need Obamacare”: Life And Death Is When You Need Care And Can’t Afford To Get It
The biggest health care crisis in America right now is not the inexcusably messy rollout of Obamacare.
No, far more serious is the kind of catastrophe facing people like Richard Streeter, 47, a truck driver and recreational vehicle repairman in Eugene, Ore. His problem isn’t Obamacare, but a tumor in his colon that may kill him because Obamacare didn’t come quite soon enough.
Streeter had health insurance for decades, but beginning in 2008 his employer no longer offered it as an option. He says he tried to buy individual health insurance but, as a lifelong smoker in his late 40s, couldn’t find anything affordable — so he took a terrible chance and did without.
At the beginning of this year, Streeter began to notice blood in his bowel movements and discomfort in his rectum. Because he didn’t have health insurance, he put off going to the doctor and reassured himself it was just irritation from sitting too many hours.
“I thought it was driving a truck and being on your keister all day,” he told me. Finally, the pain became excruciating, and he went to a cut-rate clinic where a doctor, without examining him, suggested it might be hemorrhoids.
By September, Streeter couldn’t stand the pain any longer. He went to another doctor, who suggested a colonoscopy. The cheapest provider he could find was Dr. J. Scott Gibson, a softhearted gastroenterologist who told him that if he didn’t have insurance he would do it for $300 down and $300 more whenever he had the money.
Streeter made the 100-mile drive to Dr. Gibson’s office in McMinnville, Ore. — and received devastating news. Dr. Gibson had found advanced colon cancer.
“It was heartbreaking to see the pain on his face,” Dr. Gibson told me. “It got me very angry with people who insist that Obamacare is a train wreck, when the real train wreck is what people are experiencing every day because they can’t afford care.”
Dr. Gibson says that Streeter is the second patient he has had this year who put off getting medical attention because of lack of health insurance and now has advanced colon cancer.
So, to those Republicans protesting Obamacare: You’re right that there are appalling problems with the website, but they will be fixed. Likewise, you’re right that President Obama misled voters when he said that everyone could keep their insurance plan because that’s now manifestly not true (although they will be able to get new and better plans, sometimes for less money).
But how about showing empathy also for a far larger and more desperate group: The nearly 50 million Americans without insurance who play health care Russian roulette as a result. FamiliesUSA, a health care advocacy group that supports Obamacare, estimated last year that an American dies every 20 minutes for lack of insurance.
It has been a year since my college roommate, Scott Androes, died of prostate cancer, in part because he didn’t have insurance and thus didn’t see a doctor promptly. Scott fully acknowledged that he had made a terrible mistake in economizing on insurance, but, in a civilized country, is this a mistake that people should die from?
“Website problems are a nuisance,” Dr. Gibson said. “Life and death is when you need care and can’t afford to get it.”
The Institute of Medicine and the National Research Council this year ranked the United States health care system last or near last in several categories among 17 countries studied. The Commonwealth Fund put the United States dead last of seven industrialized countries in health care performance. And Bloomberg journalists ranked the United States health care system No. 46 in efficiency worldwide, behind Romania and Iran.
The reason is simple: While some Americans get superb care, tens of millions without insurance get marginal care. That’s one reason life expectancy is relatively low in America, and child mortality is twice as high as in some European countries. Now that’s a scandal.
Yet about half the states are refusing to expand Medicaid to cover more uninsured people — because they don’t trust Obamacare and want it to fail. The result will be more catastrophes like Streeter’s.
“I am tired of being the messenger of death,” said Dr. Gibson. “Sometimes it’s unavoidable. But when people come in who might have been saved if they could have afforded care early on, then to have to tell them that they have a potentially fatal illness — I’m very tired of that.”
Streeter met with a radiologist on Thursday and is bracing for an arduous and impoverishing battle with the cancer. There’s just one bright spot: He signed up for health care insurance under Obamacare, to take effect on Jan. 1.
For him, the tragedy isn’t that the Obamacare rollout has been full of glitches, but that it may have come too late to save his life.
By: Nicholas D. Kristof, Op-Ed Contributor, The New York Times, November 2, 2013
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