That is the message the National Center for Public Policy Research is trying to tell in a “research” “brief” that is dripping in bad faith or crap analysis. I’ll get to that part later, but now let’s look at the part where a woman is blaming Obamacare for making her insurable in her tale of Obamacare woe:
Pam Hopmann, age 63, lives in Chesterfield, Missouri….For years, Pam was covered under her husband’s employer-based plan. When he retired, she stayed on his plan for an additional 18 months via a federal law known as “COBRA.” That ran out in January of 2013…..When she looked for coverage on the individual market, she was unable to get a policy because of a congenital heart condition. [my emphasis]
She was able to get coverage through the temporary Pre-Existing Condition Insurance Plan (PCIP) created under ObamaCare for people who are high risk. She paid about $400 a month in premiums and had a $1,000 deductible, which she found reasonable….
But in September of 2013, she received a notice that her PCIP plan would be cancelled at the end of the year.
“My husband and I started trying to sign up for insurance on the exchange….
She ended up choosing a gold plan, a “$10 Copay PPO” policy from Coventry Health Care. She qualifies for a monthly subsidy, but even with that she is still paying a higher premium of $544 a month. She also has a higher deductible of $1,750.
So unpacking this Ms. Hopmann had a pre-exisiting condition. She was uninsurable on the underwritten individual insurance market as no insurance company was willing to take her on medical risk. For nine months, she was in a high risk bridge program funded by PPACA, and then went onto the Exchange where she was able to get significantly subsidized insurance without having to pass through medical underwriting. Her Exchange plan is slightly worse than her high risk plan. And for that she is pissed off.
At the individual level, this makes sense. She had something good and she lost it. It does not matter that this was the program design. It does not matter the House GOP was unwilling to increase funding for high risk pools even at the opportunity of gutting a significant chunk of the Exchanges. It does not matter that in the counterfactual universe of no PPACA, she is uninsurable as no insurer who is not state mandated to take all comers/act as insurer of last resort is going to write a policy for a 63 year old with a cardiac condition. It does not matter. She had something good and now has something less good.
Now if the wingnut welfare landing pad NCPPR was interested in arguing that Exchange subsidies should be significantly richer so Platinum level benefits are the default, this story could be made in good faith. That is not the argument they are making. The NCPPR is arguing that this woman is getting screwed by Obamacare despite the fact that in a non-PPACA world, she is uninsurable until she limps across the line for Medicare in two years.
And worst of all, this is not even the biggest piece of bullshit that they are throwing into the public discourse.
The major point of their “research brief” is to argue that Obamacare jacked up prices of policies that were available on the individual market. This time, they are slightly more sophisticated in their bullshit than Avik Roy was last fall as they attempt to create “Bronze” plans to compare quasi-like to quasi-like.
On balance, though, the exchanges caused quality to decline in these ten areas, with an average of 33 policies between eHealth and Finder that had lower premiums and lower or equal deductibles and OOPMs.
They are looking at the size of the deductible available off-Exchange in 2013 with underwritten policies compared to on-Exchange community rated policies for 2014. There are three major problems with this approach. The first is that the 2013 plans had their prices set in 2013 with 2012 claims data, while the 2014 Exchange policies were using 2013 experience and a whole lot of guesstimating. 2013 pricing is cheaper than 2014 for the same exact policy. This is a light thumb on the scale, but it is a venal sin of analysis that someone who is not trying to bullshit you would not commit.
More importantly, there are two ways for insurance companies to minimize premiums. They are actually different facets of the same strategy — don’t pay big claims. The first strategy is to only insure healthy people. That is what underwriting does. The cheap plans in Arkansas that Avik Roy touted as superior to Exchange plans last fall had 23% of all applicants denied at any rate, and 28% denied at preferred rates and uprated to much higher premiums.
The second facet is to minimize what is covered. The Arkansas plans did not cover maternity, did not cover podiatry (to be ugly for diabetics), did not cover preventative care without cost share. It did not cover much that has to be covered under PPACA compliant plans.
PPACA plans have to take all applicants, and they have to actually offer a useful benefit package. That is a bit more expensive than cherry picking healthy people and not covering significant major medical expenses.
They are offering FUD and hoping some of it splatters on bystanders in our public discourse.
brantl
Tale, not tail.
Baud
Sorry, no. Her hate of Obamacare may be based out of ignorance, but it goes to far for me to say that it “makes sense.”
brantl
Available, not availabe. Proof-reading is your friend.
OzarkHillbilly
For perspectives sake, Chesterfield MO is a largely conservative, high income municipality (suburb of STL).
Richard Mayhew
@Baud: From the individual POV, she had something really good ($400/month, $1000 deductible, same doc she always had in networtk) to something less good ($550/month, $1750 deductible, old doc out of network). She had something and lost it. Arguing counterfactuals won’t change her mind as the concrete change is real to her.
Sly
The Affordable Care Act: “The food is terrible, and the portions are too small.”
Baud
@Richard Mayhew:
If someone complains to you about the lottery because they won one week and lost the next, would you say that “makes sense” from their point if view or that it was pointless to argue counterfactuals?
BC
Best thing about Obamacare: $6300 max out-of-pocket costs each year. This is such a good benefit it never gets included when antis compare current to past.
Tommy
I say this over and over again. My health plan is 40% less. Better in every way. People need to know this.
MattF
The good news is that this kind of ‘Obamacare bit my ass’ story is becoming irrelevant. Latest news is that just under 4 million previously uninsured people are now insured, and this is just halfway through the first year.
Belafon
Relatable anecdote: We have a guy at my work who doesn’t like the new Doctor. So, we’re having a mini email conversation about the episode, and we bring up a couple of points, to which he keeps asking why they’re important. Finally, one of the other people asks “Did you even watch the episode?” After some back and forth he finally answered “I’d tuned out early so that I could delete the episode when it was over.”
Just seems like this lady. She wasn’t going to have insurance once COBRA (another government program) ends because of her condition, and she’s pissed that she’s got new insurance. She is completely missing that COBRA doesn’t continue indefinitely.
greennotGreen
Let me tell you about Obamacare.
I went part-time at my job in July, so I lost my health insurance benefits. I thought about getting COBRA because I’m a cancer survivor and I don’t want to change any of the doctors who SAVED MY LIFE, but COBRA was going to be $549/month. I went on the exchanges and found a BCBS plan whose network included my doctors, and it was $404/month. It turns out that the zero cost for doctors’ visits I thought I was getting was only for physicals, so my appointment last month cost me $123…but I’d need to have more than one of those per month to cancel out the monthly premium savings, and the deductible is doable for me. I just want to avoid being on the hook for another $114,000 surgery or having to pay full price for another five months of chemo.
Yes, I chose a slightly less generous plan for a lower monthly premium. As I see it, the plans that came into being because of Obamacare (and I hope it gets called that forever) are saving me money until I turn 65.
BTW, one of the main reasons I went part-time is so we could afford to hire my replacement since it takes awhile to develop the skills needed in my work. We don’t have any money partly because our research center is connected to a hospital that’s hurting financially because the brain-dead Republican (do I repeat myself?) administration in Tennessee chose to hurt Tennesseans and our hospitals by refusing to expand Medicaid. Turn down free money to help our citizens because it might help the Kenyan in the White House politically. And then tell the uninsured it’s Obama’s fault. FUD is right.
Alce_e_ardilla
There will always be cases like this. The AVA will help 95% of the people in the aggregate, but there will always be those5% who are screwed, over, and the Republicans will spin it as “Obamacare has failed”!
Linnaeus
The idea that anyone is “uninsurable” strikes me as perverse.
MomSense
I have health insurance for myself and my kids that I can afford. At the next enrollment, I will probably opt for the next – up silver to deal with some of the co-pays that I didn’t think I would need. If I hadn’t had ObamaCare I wouldn’t have found out that I have a thyroid problem and will need prescriptions and more regular lab work, etc.
It is a big relief to have health insurance. Even a simple day of sledding is overshadowed by the worry that it could turn out to be a disaster. This winter the kids are all getting early Xmas presents of ski passes. We would not be doing this pre ObamaCare.
bemused
You just can’t convince people who “just know”.
Patrick
I am supposed to feel sorry and have sympathy for her? Does this person not realize that prior to the ACA, people like her would not have the right to insurance? Period.
How do you have a discussion about policy when some people don’t even have a basic understanding of the facts.
mathguy
@brantl: Please wait until noon to be a proof reading d-bag. It’s too early for that.
hoodie
So, she’s bitching that she can’t get in perpetuity the gravy temp deal she got from the ACA because she fell into a niche that didn’t require chronic care. It this isn’t the essence of modern conservatism, entitlement without a clue. How do they remember to breathe?
PurpleGirl
What does FUD mean?
hoodie
@PurpleGirl: Fear, uncertainty and doubt. In this case, in bad faith.
PurpleGirl
@hoodie: Thank you.
Rob in CT
If the Dems had written the ACA such that she could’ve kept the better deal, it would’ve cost more, and the Right would’ve been screetching about that.
There is ignorance involved here, but you can patiently explain this sort of thing to people and most of the time you will NOT get “oh, huh, I get it. Still sucks for me, but..” you will get “I don’t care about that, this sucks for me.” It’s the flipside of F you I got mine.
MattF
@PurpleGirl: Fear, Uncertainty, and Doubt.
Roger Moore
@PurpleGirl:
FUD is “Fear, Uncertainty, and Doubt”, and is used in about the same way as “scare tactics”.
It was originally a computer industry term used to describe sales tactics used first by IBM and later by Microsoft. When a competitor came out with a product that the IBM or Microsoft couldn’t immediately compete with, they would promise that they would have a competitive version really soon. They would then use that phantom product and their industry dominance to suggest that it was foolish to go with a competitor with an uncertain future instead of the industry leader that was certain to stay around for the foreseeable future.
Keith G
Yes there are folks who are less well off, but most who experienced a change saw a change for the good.
It is my hope that folks on my side, do not doubly victimize the ones who lost a bit by denying their loss or by questioning their sincerity. One of the weaknesses of the Democrats is that they do not follow up on these issues as topics to campaign on. On many key issues, they do not invest in a marketing plan that informs the public.
Eric U.
I’m awaiting the day when people can no longer blame their asinine and inhumane policy decisions on Obamacare.
piratedan
don’t worry, I’m sure that our media betters will make sure that both sides of the story are represented faithfully, both that this woman is pissed and that Obamacare is to blame, no worries here.
Chris Andersen
My niece recently turned 26 show she lost coverage under her parents plan and had to go on the exchange to find her own plan. After spending a few hours examining the alternatives, all of which would require her to pay more than she had previous paid ($0 before, a few hundred after), she got frustrated and went on Facebook and vented, “Would someone please explain to me what is so great about Obamacare?”
You see, in her mind, Obamacare was the reason she had to start paying for her health insurance. She did not know that prior to it she might not have even been able to get insurance and it might have been considerably higher. No, she didn’t see any of that. All she saw was that she was being required to go through the hassle of signing up for insurance, pay money she didn’t have to pay before, and it was all Obama’s fault.
Fortunately, she got disabused of some of these notions by those who responded to her post. But she was still bitter about it even several weeks later.
The message here for Democrats is that as more young adults move off their parent’s policies they will encounter a similar experience and who will they blame for it? The Democrats who “forced” them to do it.
Fr33d0m
@Belafon: More specifically, she is expecting the same coverage for the same price or less. These repugnicons should learn the first principal of repugniconism–“Those who want the guberment to give them something are suckers.”
Oh, and she bought a Gold plan.
Rob in CT
@Chris Andersen:
Sigh.
JaneE
The way to deal with this is to start calling her a leach who wants to suck the public teat for all it’s worth. Say that the only problem was being too generous to her worthless ass in the first place. Tell her she never should have been allowed coverage when her COBRA ran out. Make her feel guilty for wanting to have medical care, period. Tell her she has no right being pissed at the government for coming to its senses and trying to make her a little more responsible for her own care. In short, treat her the same way Republicans treat all the other undeserving people getting health care through the ACA. She may think she deserves to have health care, but she is no better than any one else.
You can’t fix stupid, but you might be able to shame it into silence.
JR in WV
@Chris Andersen:
Well, if saying Obamacare makes it possible for you to have health care at all won’t do it, then the person in question is unable to think, and is therefore not worth talking to.
I’m lacking patience with people who won’t look up enough real data to be able to make their best decisions about health care, people who don’t care that before ACA they likely wouldn’t have had heatlhcare insurance at all, ever, even it that meant that they were going to DIE.
The health care insurance business was in large part a giant leech that had inserted itself between people needing health care and people prepared to provide health care for a price to be determined later. (No offense to “Mayhew Insurance” intended.)
We’ve begun the slow process of diminishing the effects of that giant leech on the economy, which has already reduced the out-of-control rise in health care costs including the portion eaten by the leech. This short term gain is good for all but the health care insurance leech, but is just a tiny start in repairing the health care industry as a whole in America.
The health care insurance leech is still very hungry, has lots of political power, and will do whatever it can to reinsert itself into any arrangements it can interfere with to increase profits. It doesn’t care about individuals and their health at all, in fact if it can profit by damaging people, that’s OK by the leech. Whatever it can do to make more money is OK by the leech.
Keep up the good work, Richard!
Rob in CT
Gonna disagree a bit here. Insurance, properly regulated, is not a high-profit-margin industry (properly regulated includes things like the PPACA’s requirement that 80% of premiums get spent on care, and of course getting rid of excessive recession and refusal to rate due to pre-existing conditions). Medicare for all is still insurance, it’s just government run instead of privately run and government regulated.
I think from here on out (post ACA), the battle isn’t with the health insurance industry. It’s actually providers (doctors, drug companies, medical device manufacturers) who have eye-popping profit margins. Nobody wants to accuse doctors of gouging, so by and large nobody does it. But some of ’em do. Likewise with ordering all sorts of tests & proceedures. “Defensive medicine” is usually the excuse, but some of it is just people responding to financial incentives. People do hate on the drug companies, which seems to be basically on target, so there’s that I guess.
rikyrah
Glad you pointed out the flaws in her whining
Chris Andersen
@JR in WV:
We all would wish people were smarter about these things and knew the details better than they do. But it behooves the Democrats to be aware of the fact that a lot of people aren’t that aware and will hold them to blame when it comes time for them to sign up through the exchanges.
In other words, even if they are dumb, it’s dumb not to plan for their dumbness.
Nutella
Chesterfield MO is the ultimate “keep the government out of my Medicare” place. It was an area of soybean fields known as Chesterfield Bottoms until 25 years ago and then white flight from St Louis filled it up with housing developments and shopping malls. They were all thrilled to be away from the nears in the city (welfare mothers, every one!) and all happily paid the small line item on their property tax bill to cover the agricultural levee that was just high enough to keep the Missouri River out of the soybean fields in a typical year. Then the 1993 floods came and the agricultural levee was, not surprisingly, unable to keep the river out of the new buildings and the shiny new town of Chesterfield was under water.
All those stalwart independent Republicans, led by their stalwart Republican congressman Jim Talent, then screamed and shouted for the government to take care of their (completely predictable) problems. They were very upset that Earth City downstream wasn’t flooded. Just because they had spent $13 million of tax money to build adequate levees shouldn’t mean they should be better off than Chesterfield. They never considered, of course, going back to the city of St Louis on the highest ground for miles around because everybody knows it’s full of those terrible people who are always demanding government handouts.
That’s Chesterfield for you in 1993. I don’t expect it’s much different there now.
Patricia Kayden
Does her whining matter at this point? A few “sad” stories don’t matter given the overall effectiveness of the ACA. If Republicans are counting on these few “horror” stories to repeal Obamacare, I can assure them that won’t happen. The ACA is here to stay.
PhoenixRising
Are we sure that there is no benefit to trying to explain the facts of life to these whiners?
I could write her a check for the increase in her premium & OOP max in 2015 + 2016 (after which she will be sucking that big government Medicare teat, the leech) out of my OOP max under my pre-ACA plan, which we reached in 19 days of cancer.
And take my family to Hawaii for 2 weeks with what’s left.
And also pay my premiums for those 2 years.
And I’m not even 63!! with a heart condition!!!!!! that probably requires a doctor !!!!! to spend time and run tests $$$$$.
Shorter: Yes, it’s expensive to buy health insurance in our capitalist system. Fight for single payer, dumbass!
Cricket
@Tommy: Yours is cheaper because someone else is paying more. Naturally you’re happy, and naturally the people who have to pay for it aren’t as enthusiastic.
Yours is pretty well the flip side of the lady who’s the subject of this blog entry’s situation. You traded up, you’re happy. She had a sweet deal, lost it to a less-sweet deal, and she’s miffed.
(The Obamacare exchange plan doesn’t cover her physicians. That’s a big deal too, which other commenters have missed.)
Obamacare takes the old system and adds on a lot of requirements, paperwork, bureaucrats, and middlemen, plus a lot of people who don’t pay. All that costs more, so, on average, the usual person has to pay more.
Eolirin
@Cricket: The somewhat better deal she was getting was *also* part of the ACA. The counterfactual of no ACA for that woman was no insurance *at all*.
And no, it doesn’t mean that costs, on average, go up, because the industry is more regulated now, the exchange pools are larger than the individual market pools were, there are bits that change incentives on the provider end to bring costs down, and those things all bring costs to the consumer down. The effects of the ACA cannot be reduced to the old system + more bureaucrats.
xian
@Cricket: that’s incredibly incorrect.