“The Last People We Should Take At Their Word”: In Shocking Development, Health Insurance Companies Still Suck
The Affordable Care Act was designed to solve the big problem of health security—namely that nobody in America had it—and find a way to get coverage for the 50 million Americans who were uninsured. It also attempted to address lots of other problems, and this week it’s a good time to remind ourselves that many of its provisions came about because, to put it bluntly, health-insurance companies are despicable scum who will literally kill people (more on this below) if it makes them more money. I bring this up because now, people in the news media are learning about a scam insurance companies are trying to pull on some of their customers, and are not only not portraying it as such, but are simply taking the insurance companies’ word and blaming the whole thing on the Obama administration.
I realize that part about “despicable scum” is a little intemperate, and without question there are employees of the insurers who are good people. But as a whole, outside of the tobacco companies or gun manufacturers it’s hard to find an industry that so frequently destroys people’s lives when they’re at their most vulnerable and fools so many people into thinking they’re safe when they aren’t. Because of the shocking behavior insurance companies are capable of, the ACA had a number of provisions meant to rein in the companies from their most horrific abuses. It made lifetime caps on coverage illegal, meaning that people with the worst illnesses and accidents won’t go bankrupt because their insurance companies abandon them. It outlawed denials for pre-existing conditions. It banned “rescission”—remember that one? That’s when you get the worst news of your life, for instance that you have cancer, and the insurance company swings into action. They start poring over every document you’ve ever signed to see if they can come up with a reason to kick you off your coverage and avoid paying for that expensive treatment. Like the woman who got a cancer diagnosis and was scheduled for a double mastectomy, then got booted from her policy because her insurance company’s diligent efforts unearthed that she had forgotten to tell them she had once been treated for acne, which allowed them to claim that her original application for insurance was fraudulent and therefore they could rescind her whole policy.
That’s what I mean when I talk about them literally killing people. If someone has a life-threatening illness and will die without treatment, and then the insurance company to which they’ve been dutifully paying premiums decides to say “screw you” and make it impossible for them to get treated, then that’s an accurate way to describe it.
And as you’ve heard, these very same companies are now sending letters to thousands of their customers, telling them that the policies they’re on (which in many cases are junk insurance that covers virtually nothing) are being cancelled, and they’ll now have to pay hundreds of dollars more every month. Those customers are naturally aghast. And reporters are running to find them and air stories about the horrible “rate shock” Obamacare is producing. What those reporters aren’t doing is asking what you’d think would be relevant questions, particularly since it’s health insurance companies we’re talking about. Questions like: Is this letter accurate? Is there something the insurance company isn’t telling this customer? Might they be trying to pull a fast one, to maximize their profits at this person’s expense?
Even though it was only last week, I think I was among the first to raise the possibility that these cancellation letters are a scam, and now it’s looking more and more like that is indeed the case. One after another of the people who have been featured on breathless news stories about insurance cancellations turns out to have much better options on the new health insurance exchanges, in many cases for better coverage at lower prices than they’re paying now. The letters appear to be an effort to lock customers into high-priced policies before they discover that they have other options available to them. But we aren’t finding out about that from the big media outlets, who just prefer to run the same credulous story over and over about the 60-year-old Florida woman with a $54 a month joke of an insurance plan whose insurance company is trying to sell her a plan for many times as much.
This whole thing should serve as a reminder that while the ACA tried to create a regulatory framework that would curb the worst abuses of the insurance industry, the whole thing was also engineered to maintain the position and profits of that very industry. And if you think they suddenly decided to value their customers’ physical and financial health over their own profits, you’ve got another thing coming.
While we’re on the topic, Brian Beutler gives us something else to think about:
Let this be a reminder to the Democrats on Capitol Hill and in the White House who killed the public option. It could’ve been designed as a default plan for cancelees. And its very existence would have imposed discipline on the system — if everyone knew they can enroll in a plan modeled on Medicare, insurers would be less inclined to swindle their customers. Ironically, but predictably, the Democrats who will face the greatest political consequences of the turbulent final throes of the old individual market are in many cases the ones responsible for leaving it in the hands of for-profit insurers. But there’s plenty of blame to go around here, including to reporters treating missives from health insurance companies as reliable testimony.
You’ll remember the absolute horror with which Republicans greeted the possibility of a public option being included in the law. They were terrified that if Americans were allowed to choose to enter a Medicare-like program, lots of them would do it, and the insurance companies would lose customers. This was a perfectly legitimate fear; if Medicare is any indication, a public option would have likely been less expensive than private insurance and produced happy customers, and every person who chose to get their insurance from it would represent a rejection of conservative ideology. President Obama claimed he favored the inclusion of a public option, but never displayed any enthusiasm for it and seemed eager to drop it as one of the many failed gestures intended to win the Republican support that never materialized.
That may be a topic to revisit on another day. But if there’s any rule that reporters should follow when reporting on the rollout of the ACA, it’s this: Don’t take insurance companies at their word. They’ve already shown us who they are, and there’s no reason to think they’ve changed.
By: Paul Waldman, Contributing Editor, The American Prospect, November 5, 2013
“Hello Public Option”: The Public’s Inch-Deep Hate Affair With The Individual Mandate
Maybe the individual mandate is doomed, as an agitated-slash-celebratory Twitterverse seemed convinced after conservative Supreme Court justices posed challenging questions about it (shocking!) on the second day of arguments on the Affordable Care Act. If the justices vote later this year to kill it, with the possibility that the whole law will collapse as a result, Republicans would be vindicated in their fight against “big government.” But in practical terms, would the country really know what it has lost?
From a political standpoint, the mandate invented by the GOP of yore (“yore” being a dozen years ago) has been manna for today’s GOP. Polling shows the requirement to buy insurance or pay a fine — meant to discourage freeloaders — has become highly unpopular. Strangely, the dreaded mandate is not particularly unpopular in Massachusetts, the only state that charges penalties for not buying coverage.
Disapproval of the individual mandate nationally, meanwhile, seems to be a mile wide but not all that deep. There’s evidence that many people don’t understand what it is, why it is, and how it would affect them, and that their answers change depending on word choice and word sequence.
They like it better – about even with disapprovers in a Pew poll — if the last thing they hear is about subsidies to help lower-income people buy insurance. They like it somewhat when it’s explained that without it, people would just buy insurance when they got sick (driving up costs for everyone) or alternatively, insurance companies could not be required to cover people with existing medical problems (because without a mandate, there wouldn’t be enough healthy people in the pool). They like it best – 61 percent approval in a Kaiser Family Foundation poll — when they’re told it won’t apply to most people because they have insurance through work.
That spike to 61 percent, nearly twice as high as the 33 percent who support the mandate when asked a simple up-or-down question, is telling. It suggests many Americans aren’t comrades-in-arms with conservatives waging an ideological battle – they’re just people nervous about change and relieved to hear it won’t affect them.
Attitudes toward the overall health law are just as complicated as those toward the mandate. A new CNN/ORC International poll, like most polls, finds that the law is unpopular – favored by 43 percent, opposed by 50 percent. Breaking down the numbers further, CNN found 43 percent favor it, 37 percent oppose the law because it’s too liberal, and 10 percent oppose it because it’s not liberal enough. Hello public option!
You have to wonder if that 10 percent – which has gone as high as 14 percent in earlier CNN polls – keeps doggedly voicing opposition to the law in hopes the Supreme Court will strike it down and force Congress to regroup. At some point, as 50 million uninsured rises to 60 million and 70 million and higher, as more states approach the astonishing Texas rate of 26 percent uninsured, Congress may decide it has to do something. And, barred from effectively regulating the private market, there will be no options except the public option – Medicare for all.
That should be a safe course. After all, the policy already exists. But in the current climate it’s not hard to envision a conservative challenge to Medicare, and who knows what the Supreme Court might do?
By: Jill Lawrence, The National Journal, March 27, 2012
“In An Awkward Spot”: How Mitt Romney Advocated Obamacare And Lied About It
In 2009, Mitt Romney had a problem. He was running for the Republican presidential nomination, and the towering achievement of his governorship in Massachusetts — health-care reform — had been embraced by President Obama. Romneycare played almost no role in Romney’s 2008 presidential run, but the emergence of the issue onto the national agenda threatened to link Romney with a president Republicans had already come to loathe.
His solution was simple. He seized upon the one major difference between his plan and Obama’s, which was that Obama favored a public health insurance option. The public plan had commanded enormous public attention, and Romney used to it frame Masscare as a conservative reform relying on private health insurance, and against Obama’s proposal to create a government plan that, Romney claimed, would balloon into a massive entitlement. Andrew Kaczynski collects several televised appearances and one op-ed in which Romney holds up Masscare as a national model.
This tactic backfired when Obama had to jettison the public plan, and Republicans came to focus on the individual mandate as the locus of evil in Obamacare. What was once a Republican idea in good standing was now, suddenly, unconstitutional and the greatest threat to freedom in American history.
This left Romney in an awkward spot.
It’s hard to run for president as the advocate of an idea that your party considers the greatest threat to freedom in history. His response was to simply revise the past, much as he did with abortion. Romney now claimed he had never advocated a federal version of his Masscare program. Here’s Romney at the December 11 GOP presidential debate:
Speaker Gingrich said that he was for a federal individual mandate. That’s something I’ve always opposed. What we did in our state was designed by the people in our state for the needs of our state. You believe in the 10th Amendment. I believe in the 10th Amendment. The people of Massachusetts favor our plan three to one. They don’t like it, they can get rid of it. (COUGH) That’s the great thing about (COUGH) a democracy, where individuals under the 10th Amendment have the power to craft their own solutions.
The coughs are in the original transcript, for what it’s worth. I’ll leave it to the psychiatrists to say whether we ought to read anything into them.
And here’s Romney at a January 23 debate:
My health care plan, by the way, is one that under our Constitution we’re allowed to have. The people in our state chose a plan which I think is working for our state.
At the time we crafted it, I was asked time and again, “Is this something that you would have the federal government do?” I said absolutely not.
I do not support a federal mandate. I do not support a federal one-size-fits-all plan. I believe in the Constitution.
This is clearly untrue. Romney, as Kaczynski has shown, repeatedly held up the Massachusetts model in 2009. For instance, from the USA Today op-ed:
There’s a better way. And the lessons we learned in Massachusetts could help Washington find it. ..
For health care reform to succeed in Washington, the president must finally do what he promised during the campaign: Work with Republicans as well as Democrats.
Massachusetts also proved that you don’t need government insurance. Our citizens purchase private, free-market medical insurance. There is no “public option.” …
Our experience also demonstrates that getting every citizen insured doesn’t have to break the bank. First, we established incentives for those who were uninsured to buy insurance. Using tax penalties, as we did, or tax credits, as others have proposed, encourages “free riders” to take responsibility for themselves rather than pass their medical costs on to others. This doesn’t cost the government a single dollar.
The remarkable thing is that none of Romney’s opponents challenged these demonstrably false claims. If you check the transcripts of the debates, Romney simply lies about what he advocated, and then everybody lets it go.
Among other things, this underscores the sheer incompetence of his opposition. Kaczynski is an excellent researcher, but it’s not as if he had to comb the ends of the Earth to find these nuggets. He culled them from such sources as USA Today and Meet the Press. Every opposing campaign either failed to look up this basic stuff or failed to train the candidate to understand it. Romney is now on the verge of escaping with the party nomination having embraced a program his party considers inimical to freedom itself and blatantly lied about having done so without any major opponents pointing this out. It’s pretty incredible.
By: Jonathan Chait, Daily Intel, March 5, 2012
“Enormous Power” Used Badly: Olympia Snowe’s Strange Martyrdom
The retirement of Olympia Snowe, at the young (by senatorial standards) age of 65, has again dramatized the perilous condition of the Senate moderates. They have been scorned, marginalized, and hunted close to extinction. Yet the striking fact about Snowe’s career is that, far from being shunted to the sidelines, she has wielded, or been given the opportunity to wield, enormous power. She has used it, on the whole, quite badly.
When George W. Bush proposed a huge, regressive tax cut in 2001, Snowe, sitting at the heart of a decisive block of centrists, used her leverage to support the passage of a modestly smaller and less regressive version. When Barack Obama proposed a large fiscal stimulus in 2009, Snowe (citing fears of deficits that she had helped create) decided to shave a nice round $100 billion off his figure and call it a day. If a Gingrich administration proposed spending a trillion dollars to erect a 100- foot-tall solid-gold Winston Churchill statue on Mars, Snowe would no doubt decide, after careful deliberation, that the wise course was to trim the height down to 90 feet and perhaps use a cheaper bronze alloy in the base.
The characteristic Snowe episode came during the health care fight. The Obama administration, desperate to win her vote, wooed her with endless meetings and pleas, affording her a once-in-a-generation chance to not only help pass health care reform but make it smarter, more efficient, and more compassionate. Instead, Snowe tormented the administration by dangling an elusive and ever-changing criteria before their noses. She at first centered her objections around the inclusion of a public option. Democrats removed it, and she voted for the bill in the Finance Committee, only to turn against it when it reached the decisive vote on the Senate floor. Snowe complained that the process was happening too fast, and that it was too partisan, which seemed to be her way of saying she wouldn’t vote for it unless other Republicans joined her.
This may sound sensible, even admirable, if you subscribe to the notion that securing bipartisan support for major bills is inherently valuable. But it’s worth noting that moderates like Snowe and their fans worship bipartisanship for reasons that have nothing to do with good government. A Republican representing a blue state, or a Democrat representing a red state, faces an inherently precarious situation. Often she will find the demands of her party’s national base pitted against those of her home state electorate. Olympia Snowe’s worst nightmare is to have to choose between infuriating Republicans in Washington and moderate voters in Maine. Creating legislation that passes by wide margins is not done out of a desire to bring bills closer into alignment with any abstract standard of good government, but to ensure her vote sits comfortably in the middle of a wide swath of support from both sides. In a farewell op-ed in the Washington Post, Snowe complains that centrism offers no electoral rewards. For her, though, such careful positioning was a matter of political self-preservation.
The New York Times report on her departure cast the central tension of her career as pitting “her own views as a Republican centrist against pressure from fellow Republicans to support the party position.” This is a common way people think about it – there are two poles, one representing the moderate’s principled convictions, and the other representing party loyalty. The negation of one implies the presence of the other. Snowe’s career proved that it’s entirely possible to steer clear of the party line without upholding any particular notion of the public good.
By: Jonathan Chait, Daily Intel, March 2, 2012
“Lessons Of A Severe Conservative”: Mitt Romney Urged President Obama To Propose Individual Mandate
Andrew Kaczynski digs up a remarkable July 2009 op-edfrom Mitt Romney in which Romney not only brags about the effectiveness of the individual mandate in Massachusetts, but urges President Obama to support it at the federal level:
Because of President Obama’s frantic approach, health care has run off the rails. For the sake of 47 million uninsured Americans, we need to get it back on track.Health care cannot be handled the same way as the stimulus and cap-and-trade bills. With those, the president stuck to the old style of lawmaking: He threw in every special favor imaginable, ground it up and crammed it through a partisan Democratic Congress. Health care is simply too important to the economy, to employment and to America’s families to be larded up and rushed through on an artificial deadline. There’s a better way. And the lessons we learned in Massachusetts could help Washington find it.
And what were those lessons?
First, we established incentives for those who were uninsured to buy insurance. Using tax penalties, as we did, or tax credits, as others have proposed, encourages “free riders” to take responsibility for themselves rather than pass their medical costs on to others.
That, my friends, is the individual mandate. And Mitt was proud of it:
The Massachusetts reform aimed at getting virtually all our citizens insured. In that, it worked: 98% of our citizens are insured, 440,000 previously uninsured are covered and almost half of those purchased insurance on their own, with no subsidy.
And if President Obama had been willing to move forward without the public option (which he was), then Mitt Romney said he was ready to move forward with a national plan:
Republicans will join with the Democrats if the president abandons his government insurance plan, if he endeavors to craft a plan that does not burden the nation with greater debt, if he broadens his scope to reduce health costs for all Americans, and if he is willing to devote the rigorous effort, requisite time and bipartisan process that health care reform deserves.
And, as Mitt Romney made clear at the top of his op-ed, the plan he supported was one built around what he said worked in Massachusetts—including the individual mandate.
Yet despite his clear embrace of the individual mandate as part of federal health care reform, Mitt Romney has faced such a weak set of rival candidates that not a single one of them has brought this up in the twenty Republican debates.
But as fortunate as Mitt Romney has been to face such a staggeringly incompetent Republican field, he won’t be so lucky next fall. And you can bet your bottom dollar that the very first time he tries to attack President Obama over health care reform in the debates, he’s going to get this thrown right back in his face. And he’ s not going to like how it turns out.
By: Jed Lewison, Daily Kos, March 2, 2012
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