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.