Another Phony Obamacare Victim Story

In the last couple of decades, a particular technique of news-story construction has become so common that I'm sure you barely notice it as something distinctive. It's the use of a device sometimes referred to as the "exemplar," in which a policy issue is explained through the profile of one individual, whose tale usually begins and ends the story. It's ubiquitous on television news, but print reporters do it all the time as well.

As the Affordable Care Act approaches full implementation, we're seeing a lot of exemplar stories, and I've been noticing one particular type: the story of the person who seems to be getting screwed. If it were true that most Americans were indeed being made worse off by the law, that would be a good thing; we'd learn their stories and get a sense of the human cost of the law. The trouble is that in the real world, there are many more people being helped by the law than hurt by it, and even those who claim to be hurt by it aren't being hurt at all.

To see how misleading some of these exemplar stories can be, let's take this piece from last night's NBC Nightly News, which uses an exemplar named Deborah Cavallaro, a self-employed realtor from Los Angeles who buys insurance on the individual market:

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We learn in this story that her insurer is cancelling her current plan, which costs $293 a month, because it doesn't comply with the new law. They've offered her a new plan at $484 a month. That sounds like it sucks! But here are some things the story never tells us.

First, what exactly was her old plan? Deborah looks to be around 45. If she bought a plan on the individual market for $293 a month, I can guarantee you it barely deserved to be called insurance at all (I've bought insurance like this on the individual market). It probably had a deductible in the thousands of dollars and had substantial cost-sharing for any significant medical event. But the story doesn't tell us what sort of insurance she has.

Second, the reporter, Peter Alexander, tells us that "the administration points out that many people will get subsidies to offset the higher costs." So what about Deborah? Is she going to get subsidies? He doesn't say, but she well may, which would mean she wouldn't be paying more, or might actually be paying less. But again, this information is just spoken by the reporter, while the flip side—the victim of Obamacare—is presented in the form of a living, breathing person.

But wait. Maybe she's not a victim after all. How does the $484 plan her current insurer is offering compare to the other ones she could get? Did she or the reporter go to the California exchange and try to figure that out? Apparently, they didn't. But I did.

It took less than 60 seconds. Let's assume that Deborah has a high enough income that she isn't eligible for subsidies. I put in that I was 45 years old and got nine different choices for a Bronze plan, which in all likelihood most closely resembles what Deborah has now. The average monthly cost was $258, or $35 a month less than what Deborah's paying now for her bare-bones plan. And that's for a plan that, while it's the least expensive option, almost certainly involves less cost-sharing that what Deborah has to deal with now. She can get a Silver plan, with more generous coverage, for $316, only $23 more than she's paying now. Congratulations, Deborah!

I don't know why Deborah's insurance company wanted to sell her a policy for $484 a month, but when we look at all the facts, it turns out that she doesn't seem like such a victim after all.

Alexander closes the story by noting that the administration says that nearly half of all uninsured adults could get coverage for $50 a month or less. Well that's interesting. Can we meet one of those people, to learn about their struggles and triumphs? How about a story profiling someone who used to be uninsured, but is now on Medicaid and can finally see a doctor? I haven't seen many of those.

I'm not saying that there aren't going to be people who are going to end up paying more, because there are. But there are also people who are going to be paying less, and people, like Deborah, who are going to pay about the same but get better coverage. There doesn't seem to be a clear consensus on exactly how many people are going to end up paying more and how many will end up paying less, though Jonathan Cohn, one of the two or three best health-care reporters in the country, says that the experts he trusts the most "say the majority of people will probably end up paying less than they do now, as long as you account for subsidies, Medicaid, and the ability of young adults to enroll in special catastrophic plans or stay on their parents' policies." But what we do know is that 1) lots of people will pay less and get the same or better coverage than they have now; and 2) virtually everyone who pays more will be getting more.

That means that there are going to be very few people victimized by the law. Unfortunately, we seem to be seeing a lot of these stories; here's an almost identical story from CBS about a 56-year-old Florida woman that goes through the same routine: she's got an almost meaningless insurance plan ($54 a month for a 56-year-old woman? Good luck if you get sick on that plan); she got a letter from the insurer offering her a new plan for $591 dollars a month; this is terrible. The reporter, Jan Crawford, says the woman will be eligible for subsidies. How much? What kind of plans could she get? What will her actual costs be? We aren't told. When Crawford finishes, the anchor says, "Great reporting, Jan." This Florida woman has now been asked to appear on no fewer than three Fox News shows.

Journalists have a natural inclination to cover bad news over good and to be skeptical of the government, which is usually healthy. But if you aren't careful it can also lead to misleading reporting. If you're going to do a story presenting one person as a victim of the law, it might be a good idea to make sure they are what you say they are.

Comments

Thank you for your robust investigative journalism, proving someone who says their insurance has been upended a 'liar'. Did you stop to consider before posting your smears that this person was an ObamaCare supporter? That it was probably hard for them to go out and admit they were hurt by what they supported?

I am so tired of Liberals who claim this is going to work because of expanded Medicaid, subsidies, and young people staying on their parents insurance. The law, as you are well aware and choose to ignore, was sold on the premise that is would reform insurance markets, and cause a working insurance system to cover more people at a lower cost. What you describe as the utopian scenario of ObamaCare 'helping' is nothing more than a massive expansion of entitlements, where none of those being helped pay into it at all. Hardly sustainable.

So, if entitlement expansion is what the end goal is, as you yourself freely admit, why did we not just do that, instead of ruining the working insurance system for everyone else? Them we could have done something more intelligent, like, say, having the Government buy up some HMOs and set up clinics where those who cannot afford private care could be treated by residents, doctors exempt from malpractice insurance, NPs, etc. And we would have been spared the spectacle of a Ron Popiel president telling us that we should buy his great product from vendors he vilifies every chance he gets.

So you have no problem with tens of thousands of people dying every year of treatable conditions because they don't have access to affordable health care? You think that is a good thing? And you have no problem paying an extra 1 to 2 grand a year because of the large number of people served by hospitals who can't and therefore don't pay their bills... causing everybody else's bills to be raised on average 100 or more bucks a month?

Did you even read spammsnyder's post? S/he clearly suggested setting up government-run clinics to help people who can't afford health care. How in the world did you get that s/he thinks it is a "good thing" for people to die from lack of care from that suggestion? Further, people who have DIFFERENT suggestions for how to help people are (obviously) not opposed to helping people--they just disagree on the best way to help people. Finally, you need to distinguish between "affordable health care" and "affordable health insurance." If we made health care truly affordable, insurance would become cheaper--except that we would need significantly less of it, since health care would be affordable and therefore we could just pay out of pocket. This focus on the cost of insurance instead of the cost of care is red herring.

The problem is that conservative insurance company CEO's, and the low information voters who believe whatever they relay to them through right wing politicians and TV/radio pundits, do NOT want the problem of uninsured people dying TO BE SOLVED AT ALL. Why doesn't the government buy up some HMO's and set up clinics? Because the right wingers and their misinformed and misled listeners would not let Congress consider it! That would be "socialism." Some of them apparently do not realize that they may give their lives one day to avoid "socialism." As they said in the '50s, better dead than Red. Thus, the cost of insurance is the ONLY part of the cost of health care that government action CAN affect, at least immediately. The right wing media (and the intimidated "neutral" media such as the big three networks) point out the horror stories of a few that are allegedly CAUSED by the reform law, ignoring the many MORE horror stories caused by the STATUS QUO, some of which the reform law can and will fix even before it is tweaked further by Congress.

But all is not lost, because the way in which insurance is paid for, and thus the access to insurance, affects the cost of health care SERVICES themselves in the long run, and even a little bit in the short run. When people are not FINANCIALLY AFRAID to go to a doctor because they have some reasonable degree of insurance, they get more preventative and screening care, along with more "coaching" by the doctor (particularly when doctors are paid SOMETHING for coaching time and not just "scratch and snip" (writing Rx and cutting). This will make people less likely to go to the ER, where human compassion (and a Reagan-era law, if that's not enough; and for a GOP debate audience last year, compassion was NOT enough!) dictates that they get short term fixes, and a referral to follow-up care, which the uninsured cannot afford. For one thing, they can go to a doctor at a reasonable copay cost for minor illnesses, and follow-up care such as managing diabetes or hypertension. That way, their chronic illnesses are less likely to develop into a crisis that REALLY needs an ER visit. This will save the ER for injuries and crises that had never been diagnosed at all (as in the undetected aneurism or malformed heart valve).

Our models for insurance for medical care were developed in the days when, for many illnesses, doctors could not do very much, and very little of what they COULD do required expensive equipment or long term use of expensive drugs (which, by their nature, require long term use of repeated lab tests to make sure the dosage is correct). In those days, you EITHER missed a few days of work and had a modest doctor bill and hospital bill (because hospitals basically fed and housed you, administered drugs, kept you comfortable, and gave the doctor a place to find you every day for "rounds"), OR you stayed in the hospital a few days and died before you had a chance to run up a bill for your family to pay. In a very few cases, the hospital stay and surgery, whether successful or not, required an insurance claim to pay it.

Today, if you add up all the SCREENING tests that are recommended by doctors for HEALTHY people to get, as often as doctors say you SHOULD get them, at the "sticker price" which uninsured patients are charged, this ALONE is more than the median income of all Americans! And people who have already been diagnosed with a chronic disease, such as diabetes, need additional, and frequent, testing, in addition to maintenance prescription drugs. Essentially, for THOSE expenses, part of a health insurance policy is a "Costco wholesale club" to prepay them in pooled bulk prices. And then the TRUE insurance, protection against rare but very costly losses, is added on to that. So, barring very cheap mass produced automated testing tools (example: a $50 plugin device for your smartphone that clamps on your finger and uses IR spectroscopy to check your blood sugar, combined with an app that tells you when you need an insulin shot) substituting for doctor visits, medical lab tests, and X-ray imaging, it is VERY unlikely that the base price of the irreducible safe amount of medical attention could be brought down to be affordable. Unless, that is, the economic rules are tilted back toward working people again, as they were from the 1930s to the 1970s. And the right wing is TOTALLY against that, even though most of their misled voters would benefit!

I hope and pray that a single-payer plan, combined with incentives for greater efficiency in data sharing between different providers tending to the same patient, and more self-testing tools, is eventually formed to replace Obamacare. But, let's face it, those who say repeal FIRST and THEN replace do NOT want to replace. They have had 65 years of opposition to ALL proposed solutions (we barely got Medicare -- or Johnsoncare -- passed by restricting it ONLY to the elderly) and have NOT proposed any alternatives EXCEPT when a progressive solution is proposed, they they want to "study" alternatives before doing ANYTHING.

If you follow science, think of this: the young Stephen Hawking, before he was "Doctor" Hawking, was diagnosed with ALS (Lou Gehrig's disease on this side of the pond; the Brits say who?) and received, at no cost to him (as a not-yet-affluent graduate student), the best medical and nursing care that his country could offer. Because of that care, he was able to BECOME productive, in fact VERY productive, to society. FORTUNATELY for humanity, he was NOT BORN IN THE UNITED STATES. Had he been an American, he would have NOT received the special nursing care, maintenance treatment to slow down his disease, and assistance to read and speak through prosthetics, that helped him to become perhaps the greatest physicist since Albert Einstein, and he would probably have only lived about ten more miserable years after that diagnosis. I hope that in a FUTURE America, another young man or woman like Dr. Hawking WILL be able to overcome such a health challenge WITHOUT having to be wealthy already.

This article is complete fiction
1) HOW do you know what insurance she has now? You are ASSUMING she has poor insurance right now.

2) Do some ACTUAL research. According to KP.ORG the plan for a 45/year Old Woman in the $415 range is the Copayment 50 plan. That has $0, yes ZERO deductible, and only $50 copays for dr. visits and a 0% Coinsurance, yes ZERO PERCENT!

3) So a broken leg in this plan, would be $50 for the visit, $10 for the x-ray. For a total of $60

4) NOW, the OBAMACARE silver plan(Kaiser Silver 70), which is $416/month is a $2000 deductible, with a 20% co-insurance and a MAXIMUM of $6350 Out of pocket.

5) So a Broken Leg on this plan would be an UNKNOWN amount, with the consumer paying 100% of the first $2000 and 20% of the remainder, up to $6350! So, the same injury could LITERALLY cost 100 TIMES as much, one hundred times!

HOW in the WORLD is the OBAMACARE better? Please let me know.

jvan, you published a few different numbers in these comments, but the numbers that you publish actually SUPPORT the premise of the article.. depending on how old this woman actually is.

I looked up these numbers also, both at Kaiser and at the Covered California site. I also looked very carefully at the clip from NBC. You (and I before I looked carefully at the clip) assumed that the woman might be on something like Kaiser permanante's plan. But no, she was on a Anthem Blue Cross Clearprotection 5000 plan. Here are some of the details of that plan: Deductible: $5,000. 40% coinsurance. Out of pocket limit $8,500. It does include a reasonable prescription drug plan as long as the person is on "regular" medications. It is considered an "A" rated plan. There are more details available online, along with the statement that this plan is no longer available. It's very much like a bronze plan except that the out-of-pocket limit is lower. Of course, health insurance policies have always gone up every year, so we have no idea how much her premium would have increased if her old plan was still available.

Back to the story: First of all, all of the numbers that you are posting about ObamaCare plans assume NO tax credit.. Therefore, that this single woman, getting insurance for herself and herself only, makes at least $45,000 a year. The reality is that many, perhaps most, single women who need health insurance (don't have employer-provided health insurance) make less, probably a lot less, than 45K a year.

We don't know her health situation.. We can assume that her health is good enough for her to be insured at a reasonable rate NOW. If she experienced a health problem under the old pre-ObamaCares system, she could be dropped. Then all of this nit-picking about which plan is better would be meaningless as the poor woman wouldn't have any health insurance at all... or she would be trying to decide if she could really afford a thousand dollars or more a month.. or if she should risk going without health insurance at all. You don't mention that, and, believe me, when you start to get into your 40's, every year brings with it more of a chance of something that will turn into a "pre-existing condition".

Now... This woman, middle aged, higher income, good health, had a plan with a 5,000 deductible and a limit of 8,500 that cost her $293 a month. She doesn't want to pay $494 a month. And the Republicans are making it seem as if that is her only choice. But you, jvan as well as the author of this article, have shown us that, if she is indeed only 45 or 50 years old, she has plenty of choices, almost all of them much less than $494 a month.

Let's look at plans under ObamaCares that cost about $300/month, which is about what she was paying. First of all, there is a big jump in premiums between people who are 45 and people who are 55. We really don't know how old she is, and I personally think she is a bit older than the 45 years of age that the author of this article estimated. If she is 45, all of the bronze plans are better than what she now has in terms of deductible and annual payouts, and none of them exceed $277 a month. Additionally, 5 silver plans have a premium less than $328/month and are better in terms of copayments and deductibles. Also, 2 gold plans are less than $325 a month.

Unfortunately, if she is older, her premiums will be higher... If she is in her 60's, she will only find plans, including bronze plans, that have premiums in the $400's. That bronze plan, however, also has a deductible of 5000K, but a lower annual out-of-pocket limit of $6350 than her current plan. Of course, she can't be dumped from her insurance if she, like so many people in their 60's, develops some kind of health condition. People in their mid 50's are going to be paying at least $300/month for bronze plans, and at least $400/month for silver plans.

So here is the bottom line: If she is in her upper 50's or 60's, she will be one of these people who will be paying more for a similar plan (bronze) to the one she had, but she can't be dropped, which is a big think when you get into your upper 50's or 60's. If she is only 45 or 50, she has plenty of options, some of them even cheaper than what she was paying.

Age is the key here, as is her income (in terms of whether or not she is eligible for subsidies)......... and we don't know either of those things.

I made a couple of typos: Should be "which is a big THING" in my second to last paragraph. Also, when talking about her old plan vs. the ObamaCares bronze plan, I meant to say "all of the bronze plans are equal or better than she she has now".

I have given up on the whole debate as the majority of posters have no intention of changing their mind when presented with facts that do not agree with their POV. Both the left and the right have extremes that need to be ignored but good God if every discussion boils down to the "it didn't work as advertised and/or I hate the very idea of it" and "your side sabotaged it and you really want to declare WASP theocratic law supreme" then what hope is there of coming together?

I do understand that we seem to simply go back-and-forth all the time. But I’m trying just to present the ACTUAL numbers I’m seeing as a consumer of health care. And I am, for real, seeing huge increases in costs. There very well MIGHT be some consumers who are seeing decreases in costs, but it’s not me or anyone I know. My friends, acquaintances, and I are very concerned with our future ability to afford healthcare.

I am frustrated in seeing these articles that simply ASSUME the ObamaCare will be more affordable. When anyone can simply log in to CoveredCA and KP.org and compare the pre-ObamaCare to the post-ObamaCare prices. And there is no way anyone could reasonably say that the ObamaCare is more affordable.

Here's the bottom line: We have millions of people going without insurance now because they can't afford it and/or don't have jobs that provide health insurance. We have millions more with substandard health insurance that won't offer much financial protection if they (or a family member) gets ill. We have tens of thousands of people dying needlessly every year from treatable illnesses because they don't have health insurance. We have hundreds of thousands, perhaps millions, of people overpopulating emergency rooms because they don't have primary care.. or their treatable condition has escalated to an emergency because they don't have access to health care. We have hundreds of thousands of people who will have to file for bankruptcy or sell their homes because they don't have adequate (or any) health insurance.

I personally think that the above complex of situations is absurd in a country as rich and as "developed" as ours.

Is ObamaCares perfect? Not by a long shot. Is it better than allowing all of the above listed situations to continue in this country that is supposed to be a beacon for the world? Well.. that's the question for you and any naysayers to answer. What should we expect, those of us lucky enough to be living in this supposedly top-tier country?

For what it's worth department, a snippet from the "NEWS"! There are those saying this is another "false" report. Funny, too many people saw the same thing happen at the same events.
Michelle Obama Was Board Member Of Radical Group That Supported Marxist And Pro-Terrorist SpeakerPosted by: Dom the Conservative Posted date: October 29, 2013 In: News...
Controversial ties continue to surround the Obama family as yet another odd coincidence surfaces. First Lady Michelle Obama’s Princeton classmate Toni Townes-Whitley, a senior vice president at CGI Federal, seems to be the center of a web of scandal associated with the presidential family. While Townes-Whitley was recently found out to have celebrated Christmas with the Obamas in 2010 from pictures she released on her Facebook profile and  revelation surfaced that Townes-Whitley was involved in a no bid contract to build the $678 million Obamacare website Healthcare.gov, there is yet another puzzle piece that deserves speculation.
Michelle and her classmate were active members of a radical black student organization that supported a Marxist activist. Michelle Obama promoted a “Black Solidarity” event for lecturer Manning Marable held by the Third World Center (TWC). According to Cornel West, Marable was “the best known black Marxist in the country.” The campus group was exclusively reserved for minorities, for which Michelle Obama was a board member.

The radical activities don’t end there, however. Both Michelle Obama and Townes-Whitley were members of the groups the Organization of Black Unity (OBU) and the TWC, which engaged in a confrontation on campus with Jewish students. The confrontation was brought on by the two groups’ invitation of the Palestinian Liberation Organization (PLO) Hassan Rahman, deputy UN observer, to appear on campus.
Rahman prompted a spectrum of reactions by reiterating that “the Palestinians deserve a homeland and that they are entitled to use terrorism to achieve their goal, just as American revolutionaries did against the British. We have the right to kill them if they are traitors and negotiate with the Israelis,” Rahman threatened non-PLO supporting Palestinians attending the event.
“The OBU met with Jewish students to discuss the event, and Hillel leaders affirmed Rahman’s right to speak on campus… As about 400 students poured into McCosh 50, tension replaced this short-lived calm. The entire center section of the auditorium had been reserved for TWC members, most of whom are black. The remainder of the audience, mostly Jews, filled the outer sections. OBU’s Murphy stepped to the microphone, but instead of giving a standard welcome and introduction, he noted the ‘subdued controversy’ surrounding the speech and noted that disruptions ‘would not be tolerated.’ He even mentioned the possibility of disciplinary action or prosecution. Patrolling the room were a dozen OBU members wearing security badges, a supplement to the university proctors manning the doorways. Before Rahman had said a word, hopes of a congenial atmosphere were dashed.” Does this clear-up the true picture of this flimflammery? Join a Tea Party urgently, this radical, Marxist Presidency has to be brought to a halt NOW! Pray. Amen. Convinced? Wake-up America!

We got Trouble right here in River City. That starts with T that rhymes with p and the stand for POOL!

That makes as much sense as this rant.

Yes, Virginia -- diamond rings w/quality 18K gold do indeed cost more than cubic zirconium trinkets that turn your finger green.

As is often the case, the devil is in the details. Unfortunately, far too many people prefer simplistic, non-nuanced, superficial explanations and analyses to complex issues.

Hence, the widespread dissemination within the right wing blogosphere about anecdotal accounts demonstrating the 'horrors of the ACA' ... even when it is the result of news stories which ignore cost/benefit analyses between health coverage plans available under the ACA vs. the POS pseudo-insurance plans that some folks have been relying upon.

This is like one of those nightmares where I talk and no one can hear me!
What “POS pseudo-insurance plans” are you talking about? Please see my post above. I QUOTED the price for a Kaiser Permanente Co-Pay HMO plan, this is probably one of the BEST health insurers in the country! And the plan I specified above, the Copayment 50 is one of the BEST health coverage’s in the country. It is $415/month for a 45 Year old woman in northern CA. Find ONE, ANY Obamacare plan that is even close in price and coverage.
In fact if you look around, at least in northern CA, I cannot find ANY Obamacare plan that is remotely price/coverage comparable to any similar pre-Obamacare plan. If you have some ACTUAL numbers I would love to hear them.
I am so SICK of the left simply STATING, as if it’s a given, that costs are down, yet no one can actually show any plan whose cost decreased, yet I can show many, many, whose costs have skyrocketed!
Now if you can show me where costs have decreased, That’d be awesome, because I actually have to find new health insurance now. So please do post the plan you’d recommend. (P.S. again, in Northern CA :) )

If this were the Heritage Foundation's Romneycare (which it is) the debate would be over. It's all about the n_____ in the White House, isn't it?

Because no one seems to be actually HEARING when we speak let’s just compare plans.

CHEAPEST Obama-BROZE plan:
Blue Shield Bronze 60:
$249/Month
$4500 Deductible
40% Co-insurance
40% Copayments for all services
$6350 Maximum Out-of-pocket
----------------------------------------------------------------------------
Pre-Obamacare Plan:
KP Deducatble 40/3000
$257/month
$3000 Deductable
20% Co-insurance
$10 Drug Copayment
$40 Other Copayment
$6000 Maximum Out-of-pocket

CHEAPEST Obama-SILVER plan:
Blue Shield Silver 70:
$307/Month
$2000 Deductible
20% Co-insurance
$19 Drug Co-payment
$45-$65 Other Co-payment
$6350 Maximum Out-of-pocket
----------------------------------------------------------------------------
Pre-Obamacare Plan:
KP Deductible 0/1500
$293/month
$1500 Deductible
0% Co-insurance (yes ZERO)
$10 Drug Co-payment
$0 Office visit copay (yes ZERO)
$3000 Maximum Out-of-pocket

PS. Sorry for the multiple posts.
But as you can see above, even when looking at Blue Shield, a lower Quality health insurance, under Obamacare, it can't even compete with pre-obamacare Kaiser Permanente , a much higher quality insurance/hospital system.

If you were to compare actually comparable plans, i.e. KP plans before and after Obamacare the difference is even MORE striking in the cost increases / coverage decreases that Obamacare has brought.

Jvanleuvan, if I understand you correctly, you are comparing pre-ACA plans (with yearly/lifetime caps that are now prohibited by law) to post-ACA plans (that have said caps removed)? Do you consider this detail to be minor?

I think the analogy from labman-57 about diamonds vs. cubic zirconia applies.

No, none of the KP plans I have listed have any yearly or lifetime caps. Those are usually reserved for very "cheap" insurance. Like $150/month plans.

Additionally, a "much more affordable" plan that can be cancelled by the provider the moment you get sick is rather different than a plan that provides guaranteed coverage.

Remember, this is one of the major reasons why healthcare reform was demanded in the first place: insurance companies saying, "Sorry, you sprained your knee 40 years ago in 6th grade, so we're not going to cover this knee replacement." Or "We see that you failed to report that you had chicken pox when you were 7, so we're going to have to cancel your coverage and you'll have to pay for those colon cancer treatments on your own." All after dutifully accepting your premiums every month for years.

That behavior is totally reprehensible on the par of the insurance companies. However I, personally, have never heard of that happening. I have been with my insurance company for 35 years (since birth) and I have a chronic ailment, and have never been denied my coverage.

But in the end, this whole concept of what the insurance companies can and cannot do becomes moot if one can no longer afford insurance.

If you want specific examples from Kaiser (and Blue Cross, natch), in California no less, here you go:

http://www.dailynews.com/general-news/20080418/insurance-reviews-set-for-kaiser-permanente-anthem-blue-cross-and-blue-shield-of-california

You mention that coverage is moot if one cannot afford it. The subject of the article could previously afford (non-guaranteed) $293/month coverage, and you found an Obamacare bronze plan for $249/month. So I think the more pertinent question is whether "affordable" coverage means anything if it can be cancelled the moment you need it.

Once again, it is horrible that insurance companies would retroactively cancel insurance. No argument from me. If you read the article you posted it was 286 policies that were incorrectly canceled, out of 9.1 MILLION policies just for KP alone. so it appears that this terrible behavior, is rather minimal.

to speak to "affordability" if we were to refer to the article in question. The lady was a 45 year old female. The Cheapest bronze plan (the same as above) is $294/month.
while for the said 45 year old female the closest Pre-Obamacare plan is: KP deductible 0/2700. $307/month which has a $2700 deductible, after which it is a 0% co-insurance (yes ZERO) a small $10 drug co-payment.

What this means is that for the same monthly premium, given, for example a broken leg (which CoveredCA stipulates costs around $7500) :

* Under the Obamacare Bronze plan it would cost the consumer $5700 to have it fixed.

* Under the pre-Obamacare it would be $2700.

So the consumer's costs more than DOUBLED! this is what I mean by Un-affordable!

So, while it's great to have a law passed to prevent retroactive cancellations, nearly DOUBLING the insurance costs probably isn't worth it. Especially to me and the people I know, as no one I know has ever been denied coverage, and now I and many of my friends/acquaintances are really thinking that our families will NOT have healthcare in the coming years.

No, that is not what the article says. It says that in a random review of 286 cases, almost 10% (26 cases) were "so clearly wrong that they needed to be reinstated right away." Those were the EGREGIOUSLY wrong cases. After that investigation of 286 random cases, the Department of Managed Health Care then ordered a larger review of all dropped policies over the previous 4 years which (as per the article) could force those companies to "reinstate thousands of dropped policies."

Again, nearly 1-in-10 of these randomly selected cases were so blatantly wrong that the regulating agency ordered them reinstated immediately. What percent do you think were just questionable? How many do you think were "justified" (e.g. the person had a legitimately relevant pre-existing condition), and what do you think is a fair result for a person that pays premiums for years only to find they have no coverage when they need it?

You mention that no one you know has ever been denied coverage; are you and yours all insured through your employers? Because rescission doesn't happen through employer-provided plans (and if you already have an employer-provided plan, then the prices on ACA exchanges are pretty much irrelevant to you anyway).

Thanks for these figures. Are there any remaining private plans that look more attractive?

Thanks for this article. Journalists need to start digging and present a larger and more accurate picture. Contact state Health Departments. Get current figures. What states are doing well and which ones need to catch up? What are outreach plans really doing? I guarantee it has little to do with any of the Congressional sub-committee hearings.
There's a heckuva lot going on that is not getting report and I want to hear those stories. Meanwhile I'm turning off the big circle jerk of punditry coming out of DC and NYC.

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