Thursday, November 07, 2013

Another Obamacare horror story debunked.

Courtesy of The Cagle Post
So on Sunday there was an op-ed published in the Wall Street Journal. The author was a reporter who had survived stage-4 cancer, Edie Littlefield Sundby, who claimed that she was kicked off of her plan becasue of Obamacare:

What happened to the president's promise, "You can keep your health plan"? Or to the promise that "You can keep your doctor"? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician. 

For a cancer patient, medical coverage is a matter of life and death. Take away people's ability to control their medical-coverage choices and they may die. I guess that's a highly effective way to control medical costs. Perhaps that's the point.

Journalist Bob Cesca decided enough was enough and wrote this:  

As you probably recall from the days before the ACA was passed, scores of customers were stripped of their insurance policies, many while suffering from life-threatening illnesses. The difference back then was once they’d lose their insurance, they were unable to qualify for a new policy due to rules against pre-existing conditions. That’s thankfully not the case with Sundby — not after the passage of the ACA, not any more. While she might be forced to switch emergency care facilities or to a new team of oncologists, she will absolutely be able to sign up for a new policy with better benefits thanks to the ACA. Conversely, four years ago, when UnitedHealthcare and others were pulling these exact same kinds of profit-making stunts, she would’ve faced bankruptcy or death or both, unable to sign up for a replacement policy. 

These are details not mentioned in context of the “Obama lied” story. 

Indeed, going back to 2009, the president continuously reassured individual policy holders that if they liked their current insurance, they could keep it. On Monday’s edition of Morning Joe, they aired a series of clips of the president saying in various forms, “If you like your plan you can keep it.” This promise hasn’t actually panned out exactly as originally conceived, forcing Mika Brzezinski to literally smack herself in the face with a stack of paper. Brzezinski continued by shouting at panelist Chris Matthews, “Why would you let your president go out and say that?!” During the ensuing melee, Scarborough held up Sundby’s WSJ op/ed, “There’s this story in the Wall Street Journal about a lady with stage-4 cancer that’s been kicked off her plan!” 

Once again, no. The ACA didn’t force Sundby off her plan. UnitedHealthcare’s profit margin was the culprit here. But regarding this alleged lie, the president was actually correct given the language of the law. 

The Affordable Care Act, as signed by the president in 2010, states quite clearly that if your individual health insurance plan was in effect prior to March 23, 2010, your plan would be grandfathered as-is, despite new rules that expand mandatory benefits and ban practices such as lifetime limits. In other words, if you signed up for an insurance policy before March of 2010, and if you like that policy, you could ostensibly keep it. It’s in the law. 

However, an implementation rule was added later by Health & Human Services which narrowed the grandfathering parameters. If the benefits of a policy were altered after that date, those policies would lose grandfathered status. Meanwhile, HHS determined that up to 67 percent of customers would lose their plans, but only as a reflection of normal trends in the system — not as the result of a sudden drop off due to the ACA. 

So when the president said, “If you like your insurance you can keep it,” he meant that the law itself wouldn’t force you to call up your insurance provider and cancel your policy if you liked it. Nor was he suggesting that an insurance company would be compelled by the law to keep you as a customer for life, irrespective of circumstances. While the law in fact prohibits the cancellation of a plan if you’re suddenly sick or injured, or if you make a mistake on your application — two common occurrences before the ACA — you can still lose your plan if you fail to pay your premium or if you lie on your paperwork. 

Here’s the kicker. The law absolutely prohibits arbitrary cancellations — except for grandfathered plans like Sundby’s UnitedHealthcare plan. Frankly, switching to a Cover California plan might be the best thing for Sundby because her grandfathered plan likely included lifetime and annual limits on coverage (bad news for cancer patients); it wasn’t required to comply with government audits to prevent excessive premium hikes; and it could’ve randomly forced her to change doctors anyway.

Did you catch that last part? Obamacare absolutely forbids insurance companies from kicking you off of newer plans, so before somebody ruins all of their fun they are working overtime to frighten their customers into signing up for newer more expensive policies now while they still can. 

I feel that this is going to continue on for some time. Bad reporting, with misleading information, gets published and spread far and wide by Fox News and Right Wing radio and then more honest reporters are left trying to put the toothpaste back into the tube.


  1. Anonymous10:26 AM

  2. Chenagrrl10:55 AM

    I work for a good sized company and every year it is insurance whiplash as a new company with a new plan is offered. We once had a choice of three or four companies. Not any more. The question this year is will the plan put forward pass muster with the federal government. I betcha it won't because large companies got a 1 year breather on Obamacare. I am tired of the whining and hypocrisy.

  3. Anonymous10:57 AM

    The fake Obamacare distress stories will be drowned out by the millions of happy stories. Unrelated, but for some reason I get really annoyed by the incorrect use of "ostensibly."

  4. Anonymous11:26 AM

    How States Actively Prevent People From Learning About Healthcare Plans

    In Georgia, Missouri, Ohio, and Tennessee, for example, health navigators are not allowed to give advice about the benefits of enrolling in Obamacare.

    ...States that resisted Obamacare in the first place seem to be, unsurprisingly, the same ones that are wary of the navigators. Florida banned navigators from working in county health departments. Texas Governor Rick Perry wanted navigators to be fingerprinted, pay a state licensing fee, and take an extra 40 hours of coursework on top of what federal law required.

    The federal government awarded $67 million to more than 100 organizations to hire the navigators, but two groups, one in Ohio and one in West Virginia, turned down their federal grants last month, a move the Ohio group attributed specifically to that state’s restrictions on navigators. Ohio had no navigators available on the day the exchanges opened, October 1, because the state mandated that they get approval from the Ohio Department of Insurance before starting work.

    Here’s a rundown of the various restrictions states have put on these helpers, from a recent series of articles by researchers from Georgetown University's Health Policy Institute, featured on the Commonwealth Fund site this week:

  5. Anonymous12:05 PM

    I wasn't alive back then, but from what I've been reading, the same 'sky is falling' stories were rampant when Medicare and Social Security were started. And there were, I'm sure, lots of glitches and adjustments in the early days of those programs.

    Now all those TPers who are screaming the loudest about this terrible soshalist President and his terrible soshalist health care law are zooming around in their Hoverounds holding up signs that say "Keep the damn government out of my Medicare and Social Security!"

  6. Anonymous1:56 PM

    There apparently has been a hacker working the ACA site to discourage folks from using the site.

    I think the comments are fantastic regarding what is and what isn’t civil disobedience.

    If this is a true hack, which it seems to be, there must be some way the perp could be traced.

  7. Anita Winecooler4:21 PM

    It's just like making sausage, not a pretty sight, but WHY in the WORLD would President Obama do this?:

    I played "insurance roulette" after being dropped for a cancer diagnosis. I had "World Class" doctors at a "World Class" hospital, before I got dropped. I had "World Class" doctors at a "World Class" hospital after I got dropped. The only difference was the cost because I was put in a high risk category. Obamacare takes care of that and then some.
    Anyhow, anything that makes Mika Brzezinski to literally smack herself in the face with a stack of paper, is something I stand firmly behind.. If she smacked Joe Scarborough in the face, even better.

  8. Anonymous7:55 PM

    This is from

    "Individual grandfathered plans can’t newly enroll people after March 23, 2010 and have that new enrollment be considered a grandfathered policy. But insurance companies can continue to offer the grandfathered plans to people who were enrolled before that date. An insurance company can also decide to stop offering a grandfathered plan. If it does, it must provide notice 90 days before the plan ends and offer enrollees other available coverage options. Learn more about plan cancellation."

    So it basically says insurance company can stop offering a grandfathered policy, sounds like a loophole to me. Maybe I am just stupid. As an update, I heard from Senator Levin, Michigan, you cannot use your savings as income. So until I find employment I have to pay the FULL AMOUNT for insurance. This doesn't seem right to me and I really believe the insurance companies are taking advantage of the system.


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