As we try to judge the short-term winners and losers from the Affordable Care Act, you can’t deny that it’s terrible to find out that your insurance plan has been cancelled. It happened all the time before Obamacare when it was a much worse fate, as there was a chance that no insurance might cover you again because of a pre-existing condition.
Still getting that cancellation letter can be disturbing. But what should be more even disturbing is discovering the insurance you were paying for is junk.
This week Diane Barrette was briefly the poster woman for the estimated 3% of America in the private insurance market who will lose their insurance and pay more to get coverage that meets the new minimum standards laid out by the ACA.
It turns out that she was paying $56 a month for a plan that covered — according to Yiddish experts — bubkis.
“She’s paying $650 a year to be uninsured,” Karen Pollitz, an insurance expert at the nonprofit Kaiser Family Foundation, told Consumer Reports. “I have to assume that she never really had to make much of a claim under this policy. She would have lost the house she’s sitting in if something serious had happened. I don’t know if she knows that.”
Still CBS News and Fox News presented her as canary in the Obamacare coal mine, suggesting her fate was indicative of the horrors waiting for millions. But even Fox’s Greta Van Susteren sussed out that Barrette’s story was bunk, Mediaite‘s Tommy Christopher — who has been doing a heroic job of debunking Obamacare “horror” stories — points out. After her appearance on Van Susteren’s show, Barrette’s further Fox News’ appearances were cancelled.
Even though Healthcare.gov is still crap, it was easy to find out that Barrette can get real coverage for under $200 a month. In fact, Consumer Report’s Nancy Metcalf did just that and discovered that Barrette qualifies for a premium subsidy of $320 a month that she could use purchase a Humana Direct Silver 4600/6300 plan for $165 a month.
“To put these two plans in perspective, let’s imagine that Ms. Barrette’s luck runs out and she receives a diagnosis of breast cancer that will cost $120,000 to treat,” Metcalf wrote. “Under her current junk plan, she would probably receive no more than a few hundred dollars of benefits for doctor visits and drugs. It wouldn’t cover her surgery, her chemotherapy, her many expensive medications, or the repeated diagnostic tests she’d likely require. She would end up with probably $119,000 of unpaid medical bills. With the Humana plan, those bills top out at $6,300 a year, no matter what.”
But shouldn’t she be able to pay $56 for nothing it she wants to! This is America where we believe in the sanctity of empty calories!
Sure, she can pay less for that under the ACA! Her penalty for not getting insurance would be $25 a month. In three years, it will be as much as $58 a month, which is about what her plan would be by then given inflation.
But here’s a spoiler: She’s going to get sick eventually.
Maybe she’d make it Medicare age before that happens, then we as taxpayers would cover most of it. Or maybe it would happen next year. Maybe she’d delay treatment when she discovered the costs. Or maybe she’d go broke and the taxpayers would end up covering the difference.
Or she can now get an affordable plan through her state’s marketplace — a plan that would likely be even cheaper if Florida Republicans had accepted Medicaid expansion — and receive the kind of basic coverage a human being deserves in the richest county in the world. To achieve this about 3% of America will likely pay more for the coverage they currently have in exchange for new protections and the end of pre-exisiting conditions. And if their insurance company doesn’t spend at least 80-85% on care, they’ll get a rebate.
America isn’t willing to do what the rest of the world has to eliminate lack of insurance as a cause of death and misery. But we’ve made a huge leap with the Affordable Care Act.
And if you need proof of this, do some fact check checking on the “horror” stories you’re hearing and you’ll realize the real horror is what the GOP is fighting to keep — our broken health care system.
