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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What if the Court rules that insurers don’t have to cover people suffering from pre-existing conditions?

The following post originally appeared on the healthinsurance.org blog.

In March, Ethan Fidler, a 10-year-old from England who had just had a tumor removed from his brain flew to Florida where doctors at the University of Florida used proton therapy to blast lingering cancer cells. (While proton therapy is widely available in Western Europe, the UK government has only recently approved funding the technology. Ethan couldn’t wait.)

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If the Individual Mandate is Struck Down, What’s Next?

The following post originally appeared on the healthinsurance.org blog.

In Sunday’s edition of the New York Times, blogger Maggie Mahar responded briefly to the question, “What would the future hold if the Supreme Court strikes down the most controversial part of the health care law, the individual mandate?” We asked Mahar to elaborate on the question in this post.

Betting the individual mandate will be upheld

Ezekiel Emanuel says he has been betting on how the Supreme Court will decide the case challenging the constitutionality of the Patient Protection and Affordable Care Act (PPACA).

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Health Wonk Review: ‘Voices from the Blogosphere’

The following post originally appeared on the healthinsurance.org blog.

This week, Maggie Mahar edits the Health Wonk Review, a biweekly compendium of the best of the health policy blogs.

Voices from the Blogosphere, May 21-June 6

I’ve decided to let the “Voices” of healthcare bloggers become the theme of this edition of Health Wonk Review. Some are passionate; others are dispassionate; some are disarmingly candid; others are angry.

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