“Stupid Obamacare!”: Profit Maximizing Private Insurance Companies Got You Down, Blame Obama
It has been said many times over the last few years that now that Democrats successfully passed a comprehensive overhaul of American health insurance, they own the health-care system, for good or ill. Every problem anyone has with health care will be blamed on Barack Obama, whether his reform had anything to do with it or not. Your kid got strep throat? It’s Obama’s fault! Doctor left a sponge in your chest cavity? Stupid Obama! Grandma died after a long illness at the age of 97? Damn you, Obama!
OK, so maybe it won’t be quite as bad as that, but pretty close. Here’s an instructive case in exactly how this plays out. Take a look at this article that ran in yesterday’s Washington Post, telling how in order to keep premiums down and attract customers, some insurers are limiting their networks. “As Americans have begun shopping for health plans on the insurance exchanges,” the article tells us, “they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.”
So insurance companies—private actors seeking to maximize profit—are making decisions that some potential customers find less than perfectly appealing. The article itself is clear about why this is happening, but in the newspaper’s print edition, the subtitle read, “Exchanges Exclude Doctors, Hospitals.” Of course, that’s completely false. The exchanges haven’t excluded any doctors and hospitals, the insurance companies offering plans on the exchanges have made a decision to exclude them. The insurance companies are perfectly free to make a different decision, but they’ve decided not to.
So the newspaper runs this story, with the headline writers mistakenly portraying what for some small number of people is an unwelcome development as a decision made by the Obama administration. Conservatives will then take articles like this and others like it, and say, “See? Obama said you could keep your doctor! He lied! This law is a disaster!” Barack Obama never said that he’d forbid any insurance company from ever changing anyone’s policy or offering policies that provide something less than spectacularly gold-plated coverage at absurdly low prices. But now, every profit-maximizing decision by a corporation becomes Barack Obama’s fault.
The second component of Barack Obama coming to own all the problems with the health-care system is that with the rollout of the ACA, you suddenly have a lot of political reporters doing stories on health care, and many of them have only the thinnest understanding of the law. That limited understanding makes it easier for them to just focus on whatever negative things are happening in health care, blaming them on the ACA, and assuring themselves that they’ve been appropriately “tough” in their reporting.
There’s nothing wrong with reporters fully exploring all the changes our ever-evolving health-care system goes through, so long as they do it accurately. But you might notice that they are completely uninterested in the stories of people who are being helped by the Affordable Care Act. Harold Pollack estimates that there are over 10 million uninsured Americans who have significant medical issues like a cancer diagnosis or diabetes, and thus find it difficult or impossible to get insurance on the individual market under the pre-ACA system. These people will now be able to get reasonably priced insurance, which for many will be literally life-saving. But journalists find these people boring and not worth talking about. They’re much more interested in people who find something problematic in the new system, and they’re working hard to find every last one of those people’s stories and share them with the country. And that’s how Barack Obama ends up owning the health-care system.
By: Paul Waldman, Contributing Editor, The American Prospect, November 22, 2013
“Such Noble Sentiments”: Why Republicans Suddenly Care, Deeply, About All Those Canceled Health Policies
Amid the current national uproar over the troubles of the Affordable Care Act, it is almost uplifting to hear the deep concern expressed by politicians, pundits, lobbyists, and corporate leaders over cancellation of existing health insurance policies. They empathize loudly with the millions of potential victims, whose plight infuriates these worthy observers. They fill hours of television and pages of print with expressions of outrage.
Suddenly everyone in Washington is intensely concerned about Americans who are losing their health insurance.
The outpouring of noble sentiment would be laudable — indeed, long overdue — if only there was any reason to believe these protestations are sincere. Sadly, the evidence points in the opposite direction, for a single obvious reason: Millions of people in this country have been losing health insurance for many years, resulting in untold thousands of serious illnesses, bankruptcies, and early deaths – but until insurance cancellations became a political embarrassment for Barack Obama, the usual right-wing reaction was silence. (Except for that awkward and revealing outburst during the Republican debates of 2012, when a live audience howled its approval for the “let him die” plan.)
For anybody who ever honestly cared about people losing their health coverage – for instance, President Obama or his Democratic predecessor Bill Clinton – the depressing statistical reality has long been plain. Every day of every year, thousands of people leave the rolls of the private insurance industry in this country, almost never voluntarily.
People often forfeit insurance after losing a job, which happened to millions during the Great Recession. At the recession’s height, when the Tea Party Republicans were fighting to kill Obamacare in the cradle, more than 44,000 people were losing their health coverage every week. In May 2009, the policy journal Health Affairs published a projection that nearly 7 million Americans would lose coverage by the end of 2010.
People also lose insurance because their insurance company doesn’t want to pay the cost of a grave illness (having gorged on costly premiums for years), which has happened to many thousands more. The most recent congressional report on the subject found that three major insurance companies had saved at least $300 million through “rescission” of policies held by 20,000 seriously ill clients, while their profits mounted.
Or people lose insurance because the cost rises and they can no longer afford it, which happens routinely to nearly half the population at some point during every decade. A report released by the Treasury four years ago found that “nearly half of non-elderly Americans” had lived without health coverage at some point between 1997 and 2006, a period of relative prosperity and high employment.
The consequence, as everybody ought to know by now, is that upward of 45 million Americans have gone without health insurance at any given moment since 2007. And the further consequence is that many of those uninsured – men, women, and children — go without needed health care, leading to untold suffering and premature deaths for as many as 45,000 annually, perhaps more.
But such dismal facts have never seemed to trouble the Republicans who are screaming so loudly now about the terrible toll of Obamacare. The perennial GOP attitude was set forth by neoconservative eminence Bill Kristol back in 1993, when the prime objective was to kill the nascent Clinton health plan. “There is no health care crisis,” Kristol famously declared, and for him — then a well-paid flack in the Murdoch empire — that was true enough.
After two decades of medical costs skyrocketing above inflation, threatening fiscal and economic ruin, while millions went without insurance, such smug right-wing complacency remains largely intact. The only “health care crisis” ever feared by Republicans like Kristol is the prospect that reform will help Americans – as Obamacare is already doing, despite their worst efforts.
Let’s hope that the president’s team swiftly solves the inherent problems of providing universal coverage through private insurers. It is certainly possible, if never optimal, as Massachusetts and other states seeking to advance that goal are already proving.
And meanwhile, let’s please have no illusions about this momentary flurry of concern on the right over insurance lost. It would disappear instantly and permanently — if only Obamacare could be repealed.
By: Joe Conason, Featured Post, The National Memo, November 15, 2013
“Nobody Died”: No, Obamacare’s Flaws Are Not Like Hurricane Katrina
It’s one thing for former George W. Bush flack and Sarah Palin staffer Nicolle Wallace to make a silly and self-serving link between the troubled rollout of President Obama’s Affordable Care Act and her boss’s handling of, wait for it, Hurricane Katrina. It’s another for the New York Times to pick up the cudgel and seriously make a comparison between the Affordable Care Act’s acknowledged problems and the deadly 2005 tragedy.
But that’s what the paper did Friday morning, with Michael D. Shear’s “Health Law Rollout’s Stumbles Draw Comparisons to Bush’s Hurricane Response.” Other media are using the Times piece to make the same comparison. ABC’s “Good Morning America” did a whole segment on it; as I write, the chyron on MSNBC asks “Obama’s Katrina?”
Shear put it this way:
The disastrous rollout of [Obama’s} health care law not only threatens the rest of his agenda but also raises questions about his competence in the same way that the Bush administration’s botched response to Hurricane Katrina undermined any semblance of Republican efficiency….
“The echoes to the fall of 2005 are really eerie,” said Peter D. Feaver, a top national security official in Mr. Bush’s second term. “Katrina, which is shorthand for bungled administration policy, matches to the rollout of the website.”
No, Mr. Feaver, Katrina isn’t shorthand for “bungled administration policy.” It’s an actual tragedy in which at least 1,800 people lost their lives. Thousands of others were left stranded without food or water in their flooded neighborhoods, on freeway viaducts, in hospitals and nursing homes, and in the televised hell-hole of the Superdome. A million people were displaced, some of them permanently. Whole neighborhoods remain unrestored eight years later. There was at least $123 million in destruction, twice as much as in Hurricane Sandy.
In the ACA holocaust, by comparison, an undetermined number of people may lose health insurance policies they like. Many more, perhaps millions, have been frustrated by a kludgy website. On the other hand, at least 100,000 have signed up for insurance through the exchanges and another 500,000 or so have been newly covered by Medicaid expansion.
Oh, and there have been zero deaths as a result of the ACA woes — unless you count the death of credibility among journalists and pundits who would make such a lame and cruel comparison.
In Katrina, a toxic mix of indifference to the plight of poor, black New Orleans residents and genuine colorblind incompetence made a natural disaster worse. Bush, you’ll recall, threw a birthday party for Sen. John McCain, and then flew over the ravaged Gulf region without stopping. When he did visit, he praised his lame FEMA director Michael Brown – whose job as a commissioner of the International Arabian Horse Association had been great training for running the nation’s disaster preparedness agency – with the iconic “Heckuva job, Brownie.”
Obama, by contrast, stepped forward when the website troubles emerged. “Nobody is madder than me about the fact that the website isn’t working as well as it should, which means it’s going to get fixed,” he told a crowd Oct. 21. It’s still not fixed, although it’s working better, and the president has continued to push his staff for answers and apologize for the rollout woes, last week in an interview with NBC’s Chuck Todd; last night in a press conference. “There were times I thought we got slapped around unjustly,” the president said. “This one is deserved. It’s on us.” There has been nothing close to a “Heckuva job, Brownie” moment.
Finally, in Hurricane Katrina, most of the victims were poor African-Americans. In the current ACA controversy, the vast majority of people losing their private insurance policies are young and middle-aged white men who aren’t affluent, but are doing well enough that they don’t qualify for federal subsidies. That makes the Katrina-ACA comparison particularly outrageous, especially for journalists.
All that will ultimately matter is whether and when the site gets fixed, and the turmoil in the individual market, where some people are losing policies they want to keep, subsides. We still don’t know if the president’s proposed “fix,” which should let at least some of those folks hold onto their existing insurance, is meaningful enough to quell the political panic among some Democrats and people losing insurance, yet limited enough that it doesn’t undermine the goal of getting a bigger pool of people into the individual market for ACA-approved health insurance plans (rather than the junk insurance that currently dominates the individual market).
It’s clearly a mess, with genuine political and public policy implications. It’s fine for shrill Republicans to call it Obama’s Katrina, or his Iraq, or his Iran Contra – when it comes to this president, they have no credibility and they have no shame; they’ll say anything. But for the media to pick up on the GOP narrative and sincerely compare the ACA rollout stumble to a national tragedy like Hurricane Katrina?
Someone might call it the media’s Katrina — if it was fair to use a tragedy in which thousands died as a metaphor for mere incompetence. So I’ll just call it incredibly lame.
By: Joan Walsh, Editor at Large, Salon, November 15, 2013
“Everyone Just Chill Out”: Memo To Democratic Chicken Littles, The Sky Is Not Falling
Ah, now this is what politics is supposed to be like: Ruthless Republicans, gleeful at the prospect that they might increase the net total of human suffering. Timorous Democrats, panicking at the first hint of political difficulty and rushing to assemble a circular firing squad. And the news media bringing out the “Dems In Disarray!” headlines they keep in storage for just this purpose.
The problems of the last couple weeks “could threaten Democratic priorities for years,” says Ron Brownstein. It’s just like Hurricane Katrina, says The New York Times (minus the 1,500 dead people, I guess they mean, though they don’t say so). “On the broader question of whether Obama can rebuild an effective presidency after this debacle,” says Dana Milbank, “it’s starting to look as if it may be game over.” Ruth Marcus also declares this presidency all but dead: “Can he recover? I’m sorry to say: I’m not at all confident.”
Oh please. Everyone just chill out.
It’s incredible how often reporters and pundits proclaim that what’s happening this week is the most important political development in years, and the balance of political advantage today will remain just as it is indefinitely into the future. Then a few weeks or months later things change, and they forget about what they said before, declaring once again that today’s situation is how things will be forevermore. Not long ago, people were saying that the fact that Obama couldn’t get a congressional vote authorizing a bombing campaign in Syria had crippled his presidency. Then the Republicans shut down the government, and people were saying they wouldn’t win another election in our lifetimes. That’s just in the last few months. And now people are saying that Obama’s second term, which has three years left to go, is an unrecoverable disaster.
So let’s try to see things from a less panicky perspective. The rollout has been a mess, but it’s important to remember that this period is all a preparation for the actual implementation of the law. Nothing that’s happening now is permanent. People have gotten cancellation notices, but no one has lost their coverage. The website sucked when it debuted, it sucks slightly less now, but there’s still lots of time for people to sign up for plans that take effect next year. And if things aren’t working properly by December, they’ll probably extend the open enrollment period to a point at which everything’s working. That’s a hassle, sure. But you can’t call the Affordable Care Act a failure until it takes effect and does or does not achieve its goals. That would be like calling your team’s season a failure because they lost a couple of pre-season games.
A few Democrats will probably vote today for the Republican bill that purports to address the problem of cancellations but it’s an attempt to gut the entire ACA. That’s because they’re cowards and fools, who think that they can protect themselves from a momentary political headwind by rushing into the Republicans’ arms. And you know what will happen? Nothing. You can just add this vote to the 47 prior ones repealing the law; it’ll have the same impact. It won’t ever get to the Senate, and even if it did it wouldn’t ever be signed by the President. It isn’t even worth paying attention to.
Here’s what’s going to happen. The administrative fix Obama announced yesterday will temporarily staunch the political bleeding. But it will have very little effect on the actual insurance market, which is a good thing. In some states, insurance commissioners won’t let the insurance companies continue to sell the junk plans we’ve been talking about. In others, insurers won’t want to go back and re-offer the plans they cancelled. Some of the people with the junk plans will end up keeping them, but most of them will end up going to the exchanges. Many will find that they can get subsidies, or even without them find an affordable plan. Some may find that they’re paying more for a plan that offers real insurance. Those in the latter group will grumble, but it won’t be front-page news anymore, because the media are extraordinarily fickle, and they’ve already told that story.
Over the next year, the rest of the law will be implemented. There may be problems here and there, but overall it will probably go reasonably well. There will be plenty of things Democrats can point to in order to convince people that it was a good idea, like the fact that now nobody can be denied coverage because of a pre-existing condition, or the fact that millions of people who couldn’t afford coverage or were denied before now have it. There will also be things Republicans will say to try to convince people it was a terrible idea, like the fact that premiums didn’t plummet, and health care is still expensive, and Obamacare didn’t give every little girl a pony.
And what else will happen in the next year? Other things. The economy may get worse, or it may get better. There may be a foreign crisis. Controversies we can’t yet anticipate will emerge, explode, then disappear. A young singer may move her posterior about in a suggestive manner, causing a nation to drop everything and talk about nothing else for a week. We might start talking about immigration reform again. There’s going to be another budget battle. In other words, all sorts of things could affect the next election, and the election after that.
So yes, this is a difficult period for President Obama, and for the Affordable Care Act. But everyone needs to take a deep breath and remember that things will change. They always do.
By: Paul Waldman, Contributing Editor, The American Prospect, November 15, 2015
“The Obamacare Bait And Switch”: America’s Beloved Health Insurance Industry Demonstrates Why We Needed Reform All Along
So here’s my advice: If you’re somebody who’s smoking hot about the Big Lie of the Affordable Care Act — you know, how President Obama told everybody that if they liked their current health insurance policy they could keep it — do yourself a favor. Avoid the county fair midway.
Because if you go, you’re apt to encounter a quick-handed scoundrel running a shell game, and that boy will take your money. Doubtless Obama should have said almost everybody could keep their current plan, or that 95 percent could, but he apparently found that too, um, subtle for the campaign trail.
So now old Mitt “47-percent” Romney gets to call him a liar.
But while your attention’s fixed on the president’s “mendacity,” and “paternalism,” to quote one characteristically overwrought scribe, America’s beloved health insurance industry is demonstrating exactly why we needed reform all along. Certain companies are taking advantage of the political confusion to sell people in the “individual market” far more expensive plans than they need and blame “Obamacare.”
As usual, the nation’s esteemed political media have gone along for the ride. CBS News, rapidly morphing into Fox News Lite, presented the heartbreaking tale of one Diane Barrette, a 56 year-old Floridian who got a letter from her insurance company cancelling her $54 a month policy and offering a replacement for $591 a month—a lot of money to her.
CBS correspondent Jan Crawford, deemed smart enough to cover the U.S. Supreme Court, took Barrette’s story at face value. The idea that health insurance worth having could be purchased at a monthly cost of less than a steak dinner apparently failed to arouse her reporter’s curiosity.
Poor Barrette choked up telling CBS her story, leading to several appearances on Fox News itself.
Had CBS done elementary due diligence, they’d have learned why Ms. Barrette’s plan was so cheap. Reporters who did learned that among other shortcomings, it didn’t cover hospitalization. In reality, she had no health insurance at all. A serious accident or illness might have bankrupted her—precisely the kind of ripoff the Affordable Care Act makes illegal.
Also, Barrette was taking the insurance company’s word about the cost of a replacement policy. Writing for BillMoyers.com, Joshua Holland ran her numbers through Kaiser Permanente’s subsidy calculator. With assistance from Obamacare, she can have a real policy covering preventive care and hospitalization for an out-of-pocket cost of $97 monthly, or a more generous “Silver” level plan for $209.
Now she calls it “a blessing in disguise.”
In short, CBS News couldn’t have gotten the story more backward had they tried. For its part, NBC News featured Los Angeles real estate agent Deborah Cavallaro, whose similar experience led her to conclude that “there’s nothing affordable about the Affordable Care Act.”
However, LA Times columnist Michael Hiltzik found that Cavallaro had simply failed to consult Covered California, the state’s health plan exchange. When he did so, he quickly found that “better plans than she has now are available for her to purchase today, some of them for less money.”
No doubt some among the three to five percent of Americans whose individual health care policies have been cancelled are experiencing genuine sticker shock. However, nobody should take his insurance company’s word at face value without double-checking—a task admittedly made harder by Healthcare.gov’s website meltdown.
See, when you read a story about a couple like Dean and Mary Lou Griffin of Chadd’s Ford, PA, who told the Associated Press they’d expected to be able to keep the policy they bought three years ago, what reporters aren’t asking is where they’d gotten that idea.
From President Obama? Possibly.
More likely, however, from an insurance broker. See, all providers have known about new coverage standards ever since the Affordable Care Act passed in March 2010. Since then some have clearly been “churning” the market, offering low-risk, healthy customers bargain policies they knew perfectly well would no longer pass muster come January 1, 2014.
So now come the inevitable cancellation letters, and guess what? If they were lucky—and health-wise the Griffins have been fortunate—here comes the bad news. “We’re buying insurance that we will never use and can’t possibly ever benefit from,” Dean Griffin complains. “We’re basically passing on a benefit to other people who are not otherwise able to buy basic insurance.”
Two thoughts: One, don’t get cocky, you never know.
Two, boo-hoo-hoo. You can afford it.
Meanwhile, Dylan Scott at Talking Points Memo has documented companies sending “misleading letters to consumers, trying to lock them into…more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces.” Authorities in four states have disciplined Humana affiliates for exactly that.
It’s a classic bait and switch: luring customers with unsustainably low rates, and then blaming the White House for their chicanery.
That’s basically why we needed Obamacare to begin with.
By: Gene Lyons, The National Memo, November 6, 2013
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