Health Wonk Review Is Up

David Harlow, author of David Harlow’s Health Care Law Blog hosts the newest edition of HWR.  Harlow offers a meaty summary of some of the most provocative healthcare posts that have appeared in recent weeks.  

–On Healthcare Collaboration, Dr. Kenneth Cohn suggests that if you want to herd cats, you probably have to let the cats figure out how to herd themselves: “Most physicians enjoy bottom-up processes more than top-down edicts.  They prefer being inspired to being supervised.  The only way that I know to develop a common culture is to allow physicians to play a role in shaping it. I agree. You can’t bribe them. You can’t bully them. They have to want to do it because they realize that if they work as a team, they and their patients will be better off.

Over at Managed Care Matters Joe Paduda reports that recent analysis indicates that some states’ active efforts to hinder enrollment are working,, and are partly responsible for the shortfall in Exchange enrollment
He also points out that  CMS may require health insurers selling via the federal exchanges to make sure at least 30 percent of “essential health providers” are in-network in 2015.  This in response to some complaints about networks that are allegedly too narrow.
Paduda’s note: “Which is kind of ridiculous; smaller networks are better at controlling costs and that’s a BIG part of the success criteria for health reform.”  I agree. Moreover, if you Google “Consumer Reports,” and “NCQA” and “HMO’s” you will find that the best HMOs deliver higher quality care than open-ended plans.

–Writing on Colorado Health Insurance Insider, Louise Norris explains that folks purchasing health insurance on the exchanges need to be sure they understand drug formularies. An important point.

–As the demand for high tech and mobile surges, Julie Ferguson of Workers’ Comp Insider reminds us that more and more cell tower workers are being killed. The intense pressure to meet unrelenting deadlines is undermining workers’ safety.

Brad Wright, at Wright on Health, wonders if we can make health care prices transparent so that patients can “comparison-shop.”  Wright  worries (rightly, I think, pun intended,) that even with better information, consumers aren’t likely to change their behavior much, because health care economics does not operate according to traditional market principles. When you’re sick, you’re not bargain-hunting. Most people assume (wrongly) that health care that is more expensive must be better.

Folks from the Brookings Institution have a piece up on the Health Affairs Blog, titled “Paying For a Permanent, or Semi-Permanent, Medicare Physician Payment Fix. They emphasize  that a plan that includes “off-sets for physician payment reform that support improvements in care as well as lower costs . . . could assure beneficiaries and other health care providers that these savings are not just payment cuts that must be absorbed, but steps to help reduce spending through reforms that improve care.”

This is just a small sample of some of the best recent posts. You’ll find more here.

 

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How A CBS Video About An Obamacare Victim Misled Millions- Part 2 (What the “Victim” Revealed in Our Final Interview)

“Woman Battling Kidney Cancer Losing Company Health Plan Due To Obamacare.”

That was the headline on a story that CBS’ Washington Bureau sent to its affiliates last fall.

CBS correspondent Susan McGinnis narrates the piece: “During the 10 years that Debra Fishericks has worked at Atkinson Realty, the company has provided group health insurance with manageable premiums,” McGinnis explains –“until owner Betsy Atkinson learned the policy would be terminated because it doesn’t meet the requirements of the Affordable Care Act.

“Debra has scoured the website looking for a new policy,” McGinnis adds, referring to healthcare.gov, but “so far, she cannot afford the premiums.”

“They just keep going up higher and higher when there is a pre-existing condition,” says Fishericks.

McGinnis wraps up the story: “Debra hopes that eventually she will find a plan that fits her budget so that she can still makes trips to Indiana –to visit her grandson.”

The camera then turns to Fishericks, sitting at her desk, looking at a photo of her grandson.  “If I can’t go to see him—that’s the worst,” she says.  And she begins to cry.

I was astonished: I thought most people understood that, under the Affordable Care Act, insurers can no longer charge a customer more because she suffers from a pre-existing condition.

Later, when I interviewed Fishericks, I realized that she honestly believed she was going to have to pay more for coverage because she had been diagnosed with cancer. Like a great many Americans, she didn’t understand how the ACA would protect her. Given how hard Obamacare’s opponents have worked to obscure the law’s benefits, I probably shouldn’t have been surprised.

But what shocked me is that no one at CBS’s Washington Bureau seemed to realize that what Fishericks had said just wasn’t true: not the correspondent who narrated the story, not the reporter who went down to Virginia Beach and interviewed Fishericks, not the person who edited the video.

Fifty-eight CBS stations aired the piece. Newspapers and bloggers ran with it. Nationwide, millions of Americans were left with the impression that under Obamacare, cancer patients may not be able to afford insurance.

How had this happened?

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The French Way of Cancer Treatment–Part 1

By Anya Schiffrin

Below, the opening of a compelling essay describing what happened when a cancer patient who was being treated at NYC’s Memorial Sloane Kettering went to Paris. (I have included a link that will take you to the rest of the essay, which originally appeared on Reuters.)

For a great many years, we have been told that the U.S. offers the best cancer care anywhere. Anya Schiffrin will make you think about whether that is true—and what we need to do.

At the end of the piece I’ve added a note (MM)

When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

I humored him — though my sister and I didn’t want him to go. We felt he should stay in New York City, in the apartment where we grew up. I could visit him daily there, bringing takeout from his favorite Chinese restaurant and helping my mother.

I also didn’t know what the French healthcare system would be like. I’d read it was excellent, but assumed that meant there was better access for the poor and strong primary care.. Not better cancer specialists. How could a public hospital in Paris possibly improve on Sloan Kettering’s cancer treatment? (my emphasis–mm)

After all, people come from the all over the world for treatment at Sloan Kettering. My mother and I don’t even speak French. How could we speak to nurses or doctors and help my father? How would we call a taxi or communicate with a pharmacy?

But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions.

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. Around 1 p.m. or 2 p.m. my dad would usually tell me and my mom to go get lunch. (He never seemed to be hungry.) But we were always afraid of having his name called while we were out. So we’d rush across the street, get takeout and come back to the waiting room.

We’d bring books to read. I’d use the Wi-Fi and eat the graham crackers that MSK thoughtfully left out near the coffee maker. We’d talk to each other and to the other patients and families waiting there. Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting. Total time at the Paris hospital each week: 90 minutes.

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Single-Payer Health Care: Is That What Makes France So Different? (The French Way of Cancer Care – Part 2)

In “The French Way of Cancer Treatment,”  Anya Schiffrin writes eloquently about the care that her father, Andre Schiffrin, received when he was diagnosed with stage-four-pancreatic cancer, and decided that he wanted to go to France, his birthplace, for treatment. Schiffrin had been undergoing chemotherapy at New York City’s Memorial Sloane Kettering, and his family was concerned: how could a public hospital in Paris compete with a world-class cancer center?

To their amazement, they discovered that “the French way” of caring for a cancer patient was much better suited to Schiffrin’s wants and needs—and this was not because he had been born in France.

At the end of her essay, Schiffrin suggests that “the simplicity of the French system meant that all our energy could be spent on one thing: caring for my father.”  Back in New York, she confides, “every time I sit on hold now with the billing department of my New York doctors and insurance company, I think [of] all the things French healthcare got right.”

                                      A Hybrid Public/Private System

 Many readers might assume this means France has a single-payer system, and that is the key to its simplicity and success. But in fact, France relies on a hybrid system that is not unlike Obamacare. The government picks up the tab for only about three-quarters of the nation’s healthcare bill.

(In 2013 the U.S. government paid for roughly 48% of medical care, though, this year, with the expansion of Medicaid, and millions of uninsured and under-insured Americans joining the Exchanges where the majority will receive government subsidies, Washington will cover more of the bill.  And in the years ahead, as baby- boomers age into Medicare,  government’s share will grow.

In France, “everyone is covered to a certain extent by the government’s Assurance Maladie,” explains Claire Lundberg, a New Yorker now living in Paris where she recently had a baby. “But most people also have private insurance, called a mutuelle that is either offered through their employer or bought on the private market. There’s a thriving private insurance market in France. . .  Private medical insurance is advertised on the sides of buses and alongside movie previews in theaters.”

Ninety-two percent of the French have supplemental private insurance. Many are insured through their employers, as they are here.  Patients pay 7 percent of all health care costs out of pocket.

In France payroll taxes, paid by both the employer and the employee, along with income taxes help finance the 73% of the  bill that the government covers. All told, French workers contribute around 13% of what they earn to the public sector healthcare fund.

Government Regulation Means Lower, Transparent Pricing

 While the French government does not pay all healthcare bills, it does regulate prices. Because it sets fees for medical services, pricing is transparent

This is why, in France, Schiffrin didn’t have to spend hours on the phone talking to her doctors’ and insurers’ billing departments. There was no uncertainty as to what doctors and hospitals would or should be paid.

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Subsidies: Would You Qualify? Consumer Reports Has A User-Friendly Tool That Will Tell You

 

Check out this online tool from Consumer Reports. It allows you to quickly and easily find out if you–or a relative–would be eligible for a subsidy. A great many young people don’t realize how little insurance would cost after applying the tax credit. Do them a favor, and find out for them. https://www.healthtaxcredittool.org/

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Why Are So Many Americans Confused About Obamacare? How a Video Produced by CBS’ Washington Bureau Misled Millions –Part 1

For nearly four years, poll after poll has shown that the majority of Americans remain flummoxed by Obamacare.  Many are confused; some are afraid. They don’t know what the Affordable Care Act (ACA) says, and they don’t know how it will affect their lives

From the beginning, many in the media have blamed the White House.

Early in 2011, when a CBS poll showed that only 56% of Americans said the bill’s impact had not been explained well—or even “somewhat well”– CBS senior producer Ward Sloane summed up the prevailing view: “To me, that is a Monumental Failure by the Obama Administration. . . . [my emphasis]  And it opens up a big hole for the Republicans which they have driven through with, you know, several tanks.

Because Democrats had botched explaining the legislation, Sloane argued, Republicans “can say whatever they want about the healthcare bill … whether it’s true or not, and  . . . it will resonate . . .  People are afraid. People are afraid of things that they don’t understand and they don’t know. . . The Republicans are playing to this fear and they’re doing a masterful job.”

Sloane slid over the role that reporters might play in helping the public understand an enormous—and enormously important– piece of legislation.  If Republicans were spreading disinformation, shouldn’t news organizations like CBS try to separate fact from fiction?

Network and cable news shows are in our living rooms every evening. President Barack Obama and Health and Human Services Secretary Kathleen Sebelius are not. In speeches and in press conferences Obama and Sebelius can address a handful of questions, but they cannot explain the hundreds of interlocking details that will benefit millions of Americans. The public needs an independent, informed press that will dig into the major provisions of Obamacare and explain them, not once, but again and again.

There was just one problem: As Sloane suggested, the Republicans were doing “a masterful job” of misleading the public. What he didn’t take into account is that journalists are part of “the public.”

                      The Networks Spread Fear and Confusion

Fast forward two years to the fall of 2013.

Little has changed; most Americans still don’t understand the Affordable Care Act, and many are convinced that they have been betrayed by the president they elected.

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Did President Obama “Lie” When He Said “If You Like the Policy You Have, You Can Keep It”? Context Is Everything

How many times have you heard that the President of the United State “lied” to the American people when he said “If you like the policy you have, you can keep it?”  Even some liberals have swallowed this Republican talking point.

In December, Politifact, the Tampa Times Pulitzer-prize-winning online fact-checker, went so far as to name Obama’s  statement “the lie of the year.”

Since then, the story has generated headlines like this one: ““Reporter Asks Obama, “What’s It Like to Be Called Liar of the Year?” 

What most people don’t recall is that in 2008 m when President Obama first uttered those fateful words, Politifact—the very same fact-checking organization– graded his statement as “True.”

What is going on here?

                          Context: Who Was Obama’s Audience?

It should come as no surprise that Obamacare’s opponents ripped the president’s original statement out of context. This was easy to do because so few people remember the third Obama/McCain debate that took place in Hempstead, New York, on Oct. 15, 2008.  During this debate then-Senator Obama uttered the words that would haunt him: “you can keep your plan.”  

A transcript of the debate reveals what he meant. In response to a question from the debate’s moderator, Obama laid out a thumbnail sketch of healthcare reform:  “Here’s what my plan does. If you have health insurance, then you don’t have to do anything. If you’ve got health insurance through your employer, you can keep your health insurance, keep your choice of doctor, keep your plan.”

Obama had said something similar in his second debate with McCain a week earlier, in Nashville Tennessee.  “If you’ve got health care already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor.”

Few remember that when Obama assured Americans that the Affordable Care Act would not interfere with the benefits they had, he was addressing “the majority” of insured Americans–people who worked for large companies that offered comprehensive coverage.  More than two-thirds of the American work-force is employed by firms with more than 100 workers, and at the time, 99% of large companies offered health benefits.  He was not talking to the 5% of Americans who purchased their own coverage in the individual market, or the 17% who were covered by a small firm. (Only 35% of the U.S. work-force is employed by small companies and less than half of those firms offer health insurance.)

                 Context: What Was the Issue Obama and McCain Were Addressing?

In  2008 when Americans who had good health benefits at work heard the phrase “healthcare reform,” many worried that this would mean a “government takeover” that would eliminate their employer-sponsored plans. In short, they feared a single-payer system. Obama was trying to reassure them that this wouldn’t happen.

At the time, Politifact understood that this was the concern that Obama was addressing.  Here is what Politifact’s Angie Holan wrote in October of 2008:

Obama is accurately describing his health care plan here. He advocates a program that seeks to build on the current system, rather than dismantling it and starting over. People who want to keep their current insurance should be able to do that under Obama’s plan. His description of his plan is accurate, and we rate his statement True.”

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Did the Administration Conceal the Fact That Millions Would Have to Replace Their Insurance With A New Policy?

At the end of October NBC’s Lisa Myers and Hannah Rappleye broke the story: “millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years. Four sources deeply involved in the Affordable Care Act tell NBC News that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a ‘cancellation’” letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience ‘sticker shock.’

“Buried in Obamacare regulations from July 2010,” Myers and Rappleye reported, “is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.”

In fact, NBC’s investigative team did not t need four unnamed sources “deeply involvthe ACA” to tip them off that millions of customers would be receiving these notices.

Three years earlier Health & Human Services (HHS) Secretary Kathleen Sebelius had called a press conference to announce that under the ACA, 43 million Americans working for small companies” would be moving to new plans.   Labor Secretary Hilda Solis joined her to explain that the new plans would give workers “all of the protections of Obamacare.” 

In a press release HHS spelled out the numbers: “roughly 42 million people insured through small businesses will likely transition from their current plan to one with the new Affordable Care Act protections over the next few years,” along with “17 million who are covered in the individual health insurance market.”  .

What about President Obama’s promise that “If you like your plan you can keep it”?  As I explain it the post above, when he first made this pledge, he was addressing “the majority” of insured Americans who worked for a large companies where they received generous benefits. These were the folks who “liked their plans,” and in a debate with Senator McCain, he was reassuring them that health reform would not mean dismantling employer-based insurance and moving to a single-payer system. But over time, candidate Obama made the mistake of letting his pledge turn into a sound bite. At that point, it became easy for his opponents rip that line out of its original context, and brand him a liar.

In 2013, when reporters claimed that people who received the “cancellation letters” were blind-sided, they ignored the fact people in the individual market often lost their policies. As HHS observed in its 2010 press release: “roughly 40% to two-thirds of people in the individual market normally change plans within a year,”  in part because carriers in that market routinely discontinued  policies.  Inevitably, the replacements they offered costs more and/or covered less. As a result,  Americans who purchased their own insurance were accustomed to scrambling, year after year, to find new coverage.  In the fall of 2013, neither they, nor reporters who knew anything about the individual market, should have been shocked when so many policy-holders discovered that they would not be able to renew their plans..

Was the News “Buried” In Obscure Obamacare Regulations?

Hardly. The New York Times covered the press conference in its A1 section, noting that, “the rules appear to fall short of the sweeping commitments President Obama made while trying to reassure the public” that they “could keep their current coverage if they like it.”  But, as the Times reported, the administration explained that  ”this was just one goal of the legislation.” Another goal was to make sure, as Labor Secretary Hilda Solis put it when responding to a question “that insurers don’t take advantage of their customers.” 

Originally, the Affordable Care Act had stipulated that if an insurer sold a plan before March 2010, when the ACA passed, the carrier could continue to renew that plan—even if it didn’t meet the ACA’s standards. But reformers did not want to give carriers carte blanche. As Sebelius explained at the press conference: If, after 2010, insurers (or employers) made dramatic changes to a plan, hiking deductibles or reducing benefits (“for instance, deciding to stop covering  treatments for say, HIV/AIDS or cystic fibrosis,”)  it would be considered a new plan.  At that point, the insurer would no longer be able to renew the policy and would have offer a replacement that met the ACA’s requirements for consumer protection.

Back in June 2010 the New York Times was not the only major media outlet that publicizing the rules: Fox News issued a “Special Report,” which claimed that “up to 80 percent of small businesses and 64 percent of large businesses may have to give up the plans they had today within three years,” The Report even included a video of Sebelius making the announcement.

Yet in October of 2013 Fox would claim that the press conference never happened.  On Fox & Friends, co-host Steve Doocy charged that the administration hid the facts.  “Back in 2010, they knew millions would lose [their coverage], and they didn’t say a word!”

Okay, I understand that most folks at Fox don’t start their day by skimming the New York Times. But don’t they watch Fox News?

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An Obamacare “Horror Story” That Just Isn’t True: How Did This Happen? Part 2

For months, health reform’s opponents have been trumpeting tales of Obamacare’s innocent victims Americans who lost their insurance because it doesn’t comply with the ACA’s regulations, and now have to shell out more than they can afford – or go without coverage.

Trouble is, many of those stories just aren’t true.

Below I posted about a Fort Worth Star Telegram article that leads with the tale of Whitney Johnson, a 26-year-old new mother who suffers from multiple sclerosis (MS). Her insurer just cancelled her policy, and according to Johnson, new insurance would cost her over $1,000 a month.

That claim stopped me in my tracks. Under the ACA, no 26-year-old could be charged $1,000 monthly – even if she has MS.

Obamacare prohibits insurers from charging more because a customer suffers from a pre-existing condition. This rule applies to all new policies, whether they are sold inside or outside the exchanges.

At that point, I knew that something was wrong.

When I checked the exchange – plugging in Johnson’s county and her age – I soon found a Blue Choice Gold PPO plan priced at $332 monthly (just $7 more than she had been paying for the plan that was cancelled). Co-pays to see a primary care doctor would run just $10 ($50 to visit a specialist) and she would not have to pay down the $1,500 deductible before the insurance kicked in.

My radar went up: Recently, I have been reading more and more reports regarding “fake Obamacare victims.”

Now I couldn’t help but wonder: Who are these folks in the Start-Telegram story? The paper profiled four people who supposedly had been hurt by Obamacare. When I Googled their names I soon discovered that three (including Johnson) wereTea Party members.

The paper describes them as among Obamacare’s “losers,” but the truth is that they didn’t want to be winners. Two hadn’t even attempted to check prices in the exchanges.

Meanwhile, it appeared no one at the Star-Telegram even attempted to run a background check on the sources, or fact-check their stories. I couldn’t help but wonder: “Why?”

The answer will surprise you.

Johnson finds affordable insurance …

When I tried to phone the reporter, she didn’t return multiple calls. Finally, I reached an editor at the paper. He told me that  both Yamil Berard, the reporter, and her editor were out of the office. I expressed my concern that inaccuracies in the story would discourage readers who were thinking about signing up in the exchanges. He suggested that I sounded like an “advocate” for Obamacare.

To my surprise, two hours later he called me back.

He had just received an internal email, he told me, which revealed that Whitney Johnson had found affordable insurance for $350 a month – just $25 more than the premium on her cancelled policy, and roughly what I thought she would pay in the exchange.

I asked the editor if he could send me a copy of the e-mail. “No,” he replied “It’s an internal memo.”

Would the paper publish a follow-up, acknowledging that Johnson would not have to pay $1,000 for coverage?

“I’m not sure what we’ll do with it.” He sounded cautious.

The Star-Telegram Doesn’t Tell Its Readers

To this day – more than a month after the story appeared – the Star-Telegram still hasn’t  published a follow-up, explaining that under Obamacare, no 20-something – including Johnson – will be charged $1,000 a month.

I then contacted Johnson, who confirmed that she had found a $350 Blue plan outside of the exchange. Based on the details she provided, I managed to locate it. (The premium is actually $347.92 a month.)

It turns out to be very similar to the exchange policy I had found. The premium is higher, but the deductible ($1,000 instead of $1,500) and co-pays for medications ($10/50/100 vs. $35/75/150) would be slightly lower. The provider network would be the same (Blue Choice).

The exchange plan offers a stronger safety net, and for someone with MS this could be important: If her husband’s income drops, or he loses health benefits at work, they would immediately be available for a subsidy. Because her new policy is not on the exchange, they would have to wait until open enrollment in November 2014 to sign up for a 2015 plan with subsidies.

I Talk to the Story’s Editor–and the Reporter 

Next, I spoke to Steve Kaskovich, the editor who assigned the story to Berard. He explained that he had asked the reporter to write a piece about people whose policies were cancelled, and as a result were “caught in the quagmire.”

I originally wrote this post for www.healthinsurance.org, an independent website (not connected to the insurance industry)where I, Wendell Potter, Hal Pollack, LInda Bertghold  and Louise Norris all blog.

To read the rest of this post click  here / and “Scroll down to Editor: Find People Caught In a Quagmire.” There you will discover what the editor had to say. When I finally talked to the  reporter, the truth came out. You can also hear me talking about the Star-Telegram piece –and problems with the way the media has been covering health care reform on NPR’s “Eye on the Media” . Click here: 

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Obamacare “Horror Stories”–Who Are These People? How Many of These Stories Are True? Part 1

No doubt you have seen or read stories about innocent Americans who have become casualties of Obamacare. The law that was supposed to help middle-class families is now asking them to pay unreasonable premiums and sky-high deductibles. In many cases, they had perfectly good coverage that has been cancelled because it didn’t meet the Affordable Care Act’s (ACA’s) “standards.”

Trouble is, some of these anecdotes  just aren’t true. When an unbiased  reporter begins to make some phone calls, they start to fall apart.

Nevertheless,  these tales of Americans harmed by Obamacare  are being promoted by various conservative groups–including the Republican National Committee.  An internal RNC memo provides advice on how to collect stories of “victims” and feed them to the press.

Knowing this, when I read the horror stories,  I can’t  help but wonder: have the folks who are quoted checked prices on their Exchange?  Do they know  whether they are eligible for government subsidies?   How many didn’t  even try to find out because they just don’t like the ACA?  Who are these people who step forward to  identify themselves victims of the trainwreck called Obmacare? Where did they come from? How did the reporters who wrote the stories find them?

Finally, and perhaps most importantly, are journalists  fact checking their tales? How many are just writing down whatever their sources tell them?

          A Young Mother Suffering From MS Searches For Insurance

A few weeks ago, I stumbled upon a story that ran in the Fort Worth Star Telegram on November 26. The lead is compelling:

“Whitney Johnson, an Arlington 26-year-old with multiple sclerosis, can’t afford to go without health insurance. Her life depends on it.

She gave birth to her first child Sept. 2 after undergoing a series of rigorous steroid treatments, surgeries and a plasma exchange that saved her life. She pays $325 a month for an individual insurance plan – a drop in the bucket compared with the cost of her plasma protein replacement therapy, which runs $40,000 a pop. She undergoes treatment every five weeks.

But now, with the Affordable Care Act in full swing, Johnson’s insurance is under threat.. . .

Recently, the story  explains, Johnson’s insurer sent her a letter saying that because her policy “does not comply with Obamacare” it will be cancelled Jan. 1, 2014. Initially she hoped that she might shift to her husband’s employer-based health plan  For $325 a month, it covers him and their son. But it  turns out that if Whitney were added the policy, their premium would triple.

Meanwhile, she “has been unable to access the federal health exchange website” the newspaper reports, “which has been hampered by technical problems.”

In a video talking about her experience,  Johnson claims  that when she began “trying to shop around ‘ outside the Exchange, “the rates went from $1,000 to $1,800 a month for not even close to the coverage that my previous  insurance had offered me.”

This is when I knew that there was something very wrong with Johnson’s story.

                        $1000 a Month To Insure a 26-Year- Old ???

Anyone who knows anything about Obamacare would realize that under the ACA, no 26-year-old would be asked to pay $12,000 a year – even if she had MS. Obamacare does not let insurers charge more because a customer suffers from a pre-existing condition. This rule applies to all new policies, whether they are sold inside or outside the exchanges.

And Johnson is just 26. In most exchanges, 20-somethings pay far less than older Americans.  I was certain that that she could get a much better deal. It didn’t take me long to find one.

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