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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Under Obamacare, Will Out of Pocket Spending Be Higher?

Not long ago, the Fear-Mongers were warning that under the Affordable Care Act, insurance premiums would spiral, causing “sticker shock.” Then the rates were published, and it turned out that, thanks to transparent markets in the exchanges, insurers had to compete on price, and premiums are lower than expected.  

But don’t worry, reform’s opponents haven’t run out of talking points. (I expect that long after most of the country has begun to enjoy the benefits of Obamacare, out-of-touch conservatives still will be muttering to themselves – rather like Japanese officers who held out in the jungles of the Philippines after WW II ended, unable to accept the fact that they had lost the war.)

In search of a new meme, they have latched onto the idea that, in the exchanges, customers will face “Staggering Out-of-Pocket Costs.” Sure, premiums may look low they say,, but wait until you try to use the policy and find yourself laying out $6,000. . Not long ago, Fox News summed up the argument: If the policy you bought in the individual market is cancelled because it doesn’t conform to the ACA’s rules, and you are forced to purchase coverage in an exchange, co-pays and deductibles will soon make you realize that the ACA is really “The Unaffordable Care Act.” 

Fox picked up the theme from a Bloomberg News story that went viral:“Obamacare Deductibles 26% Higher Make Cheap Rates a Risk,”  the Bloomberg headline screamed. As evidence, Bloomberg pointed to a survey of seven states, done by HealthPocket Inc., that compares the average deductible a consumer will face if he purchases a Bronze Plan in an Obamacare exchange to the average deductible in the private-sector market where 5 percent of Americans have been buying their own coverage. (These are the policies that are disappearing because they don’t meet the ACA’s standards.)

It turns out that the survey greatly exaggerates out-of-pocket spending in the Exchanges by focusing only on Bronze plan.  Meanwhile, the media ignores the most important number: what is the Maximum that an insurer can ask you to pay out of pocket?

The problem with many of the policies that are now being cancelled is not just that they were studded with holes  (some didn’t cover hospitalization; some didn’t cover chemo), but that in many states, a family could be asked to pay $30,000—or more—in co-pays and deductibles. . In a few states, there was no cap on the a patient’s liability.I This is how families lose their homes.

I’ve written about this here on healthinsurance.org. Read the entire post and, if you like, come back here to comment.

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