On May 14, 2016, Elisabeth Rosenthal writing for, "The New York Times," as a seeming apologist for Obamacare misses the reality of Obamacare in an article that typifies one of the main reasons that meaningful changes to Obamacare remain seemingly impossible and which make REPEAL the likely only rescue to the law's flaws that are working as intended to the detriment of consumers.
Barely acknowledging the reality that we were SOLD Obamacare based on inflated numbers of uninsured (“…somewhat fewer people are now projected to gain insurance coverage because of the ACA, because CBO and JCT estimate that fewer people would be uninsured in the absence of the ACA…” (March 2015, CBO, Pub. 49973 page 22) and inflated numbers of those denied health insurance because of pre-existing conditions (2/4/2011, Lori Robertson for Factcheck answered the question: "Is it true — as the Obama administration claims — that '129 million Americans with a pre-existing condition could be denied coverage without new health reform law'?" Answer: "No." http://www.factcheck.org/2011/02/millions-with-preexisting-conditions/), Ms. Rosenthal writes that the critics of the law she includes in her article "MIGHT (emphasis added) not have had insurance today without the law…[and] feel as if they have become second-class patients," http://www.nytimes.com/2016/05/15/sunday-review/sorry-we-dont-take-obamacare.html?_r=0.
She then goes on to try to justify her claim that Obamacare's problems are growing pains, implying that there is hope for the solution of these problems revealing a stunning ignorance of the law as designed and as it's working and a relentless loyalty to the lies we've been told as she discusses issues including providing less coverage outside their home states, higher costs for medicine and narrow networks--too few provider options, http://www.nytimes.com/2016/05/15/sunday-review/sorry-we-dont-take-obamacare.html?_r=0, and seems content with the meaningless promise of new strategies, specifically focusing on LABELING plans better as if a change in LABELING is all that consumers require.
For Ms. Rosenthal new LABELING will be a "fix" for Obamacare--telling us health insurance plans are standard plans, broad (for better) plans, and basic plans (for worse).
Unfortunately, neither Obamacare nor its apologists are "growing," they're grown as the article's celebration of this tweaking of Obamacare labeling shows. The Obamacare fans' hardened allegiance to the misinformation about Obamacare serves no purpose but to remain inflexibly loyal to a law that is doing JUST as it intended--incentivizing a new lower-standard of coverage and care in order to save payers, insurers and government, money on how much they spend PER INDIVIDUAL on health care, while spending UNCOUNTED sums on themselves to administer the new REDUCED coverage (the CBO early on said it wouldn't calculate those sums: “…[e]stimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…", (“Updated Estimates of the Insurance Coverage Provisions of the Affordable Care Act,” http://www.cbo.gov/sites/default/files/cbofiles/attachments/49892-breakout-AppendixB.pdf, page 1.)
This isn't changing, it's the purpose of the law and there's more to come as the law promises to reduce GOVERNMENT spending for patients on Medicare over the next several years.
Yet, the apologists are relentless in their attempts to spin every miserable fact that's created dangerous risk and discontent with Obamacare into success, beginning with the stubborn fact of lower than expected enrollment in Obamacare plans year after year (since enrollment is not cumulative but year-by-year) including this year's measly range of 9.4 and 11.4 million people (remember the 47 million?) ("…an estimated range of 9.4 to 11.4 million effectuated enrollees in the Marketplace at the end of 2016," https://aspe.hhs.gov/affordable-care-act-research.)
Back to Ms. Rosenthal's phony "growing pains" theory. The problem of under-insurance, a pre-Obamacare problem where individuals were opting out of purchasing a consumer financial product that failed to protect them from financial devastation in the face of illness even as they were charged more and more each year to purchase the product is actually worsened by Obamacare which forces people to purchase products that are often inadequate (individual mandate), creates the excuse for insurers to charge more for NEEDED medical services because of the insistence on covering the finite costs of checkups, and leaves narrow networks, higher deductibles and greater copayments, coinsurance as the choice patients must make in order to keep their costs under control.
While Ms. Rosenthal jumps on the idea that the labeling of plans will better enable consumers to see how bad their coverage is, she ignores reality--Under-insurance was a key contributor to the healthcare "crisis" and that is not about LABELING HOW BAD PLANS ARE but about how people WITH health insurance face financial peril if they get sick (one illness away from bankruptcy, remember?). Medical debt is still an enormous peril and in 2013 was the number one cause of bankruptcy, (http://www.usatoday.com/story/news/2015/02/01/consumers-still-struggling-with-medical-debt/22587749/). As revealed in a "USA Today" article, by Shefali Luthra, Kaiser Health News, 2/1/2015, of those found struggling with medical debt, 59 percent had health insurance. That is under-insurance.
But underinsurance was BUILT INTO Obamacare in order to save payers, insurance and government money. Forcing people to purchase plans that are noteworthy for their lack of sufficient in-network providers (narrow networks), noteworthy for their increased out-of-pocket expenses in the form of deductibles, copayments and coinsurance, noteworthy and for their absence of provisions for getting rid of balance billing. This isn't growing pains, this is Obamacare.
When it comes to narrow networks, Obamacare uses them the same way they've always been used--to encourage insurers to make their plans cheaper by providing fewer provider choices. Ms. Rosenthal forgives Obamacare's continuation of one of the problems that contributed to our healthcare crisis admitting that to stay cheap "41 percent of silver plans offered a 'narrow or very narrow' selection of doctors," and that Obamacare plans "tended to exclude high-cost, high-end hospitals with whom they had little clout to negotiate discounts," http://www.nytimes.com/2016/05/15/sunday-review/sorry-we-dont-take-obamacare.html?_r=0. This won't change with "growing pains," this is built into Obamacare.
Ms. Rosenthal also omits other results of the traditional insurance company tactic of providing overly narrow networks which often force people who want providers with specific qualifications for needed medical care and services or want choice to use out-of-network providers or unknowingly receive the services of out-of-network providers--the issue of BALANCE BILLING, where individuals who receive services from these non-participating providers are CHARGED the difference between whatever little amount insurance covers and whatever amount a provider chooses to charge.
Obamacare noticeably OMITS an easy fix for balance billing which would be to provide that IF CONSUMERS COMPLY WITH LAW AND PURCHASE A HEALTH INSURANCE PLAN THEY MUST BE BILLED BY PROVIDERS ACCORDING TO WHAT THEIR PLAN REIMBURSES PROVIDERS FOR--NO BALANCE BILLING--AS LONG AS CONSUMERS MAKE A REASONABLE EFFORT TO USE THE PLAN'S PARTICIPATING PROVIDERS. That's because saving CONSUMERS money was NOT a purpose of the law--that's not growing pains, it's Obamacare.
We also know that Obamacare, as a law designed to save payers, government and insurers money, sacrificed meaningful insurance coverage, contingency coverage for in the event of, for the cheap finite costs of checkups resulting in consumers paying more in copayments, coinsurance and deductibles for health insurance coverage for illness. This results in increased financial peril for individuals who actually NEED medical services. This isn't growing pains, it's the way Obamacare was designed.
Further, Obamacare INCENTIVIZES more defensive medicine and expensive testing (also a contributor to the original healthcare "crisis") because providers tell consumers to get the "free" tests, more so now that it's free, and then consumers get to pay the higher copayments, coinsurance and deductible expenses as they're sent for more testing based on "diagnosis," which is NOT COVERED by the "free" checkup.
This fix also would have been easy--INCLUDE ALL EXPENSES STEMMING FROM RESULTS OF FREE CHECKUPS to discourage channeling people into an endless cycle of "diagnostic" exercises where consumers will have to pay more in copayment, coinsurance and deductibles. This blatant exploitation is BUILT INTO Obamacare, it's not growing pains. It also further jeopardizes consumer safety since it leaves more room for medical error which is the THIRD LEADING CAUSE OF DEATH in the US.
Finally, if you still doubt Obamacare's goal was to reduce payer liability only, as in government and insurance companies, you might wonder why the out-of-pocket maximum--those costs imposed on consumers before getting 100 percent of the coverage available under their plans, during this time of stagnant wages keeps rising, which it does. In 2011 the out of pocket maximum was $5,950 for an individual and $11,900 for a family. In 2016 they're up to $6,850 for an individual and $13,700 for a family and in 2017 they're up to $7,150 for a family and $14,300 for family insurance, (http://www.benefitspro.com/2016/03/03/hhs-releases-new-out-of-pocket-maximums. That's an increase of 17 percent. This isn't growing pains, it's built into Obamacare--charge consumers more to save payers money.
Then there's the complaint that exchange plans are on the whole worse than employer plans, and Ms. Rosenthal's seems to believe Obamacare will also "grow" into better plans showing a stunning lack of understanding of Obamacare which is actually WORSENING ALL COVERAGE rather than improving coverage provided under exchange plans to better match employer plans.
Ms. Rosenthal's rosy outlook ignores the reality of what's going on with employer health plans as they too are INCENTIVIZED by Obamacare's establishment of "minimal standards" for qualified health plans while charging consumers more in premiums, deductibles, copayments and coinsurance. In addition, since the COST TO CONSUMERS of Obamacare health plans is dependent on the going rate in specific regions, when prices go up for all health plans they also go up for entitlement Obama plans (though consumers often get bailed out with federal handout bucks contributing towards premium which disguises the increases to some extent), http://obamacarefacts.com/silver-plan/, "Silver plans are the marketplace standard…second lowest cost silver plan in a state is used as the benchmark plan."
We've already seen that employer plans are sinking to the level of Obamacare plans rather than sustaining superior coverage and similar to Obamacare standards are providing less for more money. "Premiums for family coverage increased 27% during the last five years, the same rate they grew between 2005 and 2010…" (http://kff.org/report-section/ehbs-2015-summary-of-findings/) AND the government anticipates more of the same: "Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade," https://www.cbo.gov/publication/51130.
The ONLY "fixes" to Obamacare have simply INCREASED the number of people left out of access to our healthcare system through "EXEMPTIONS" from being taxed because they're excluded from access to health insurance, in stark contrast to the ridiculously false claims made by Obama to the Canadian PM that in the US there is a right to healthcare on March 13, 2016, (a lie challenged by Castro on March 22, 2016.)
The fixes to the crushing costs of gaining health insurance has been a governmental response of, "OK, you can't get health insurance, but at least we'll exempt you from the individual mandate and won't tax you on top of that." So we see that in response to the Supreme Court's decision that Medicaid expansion can't be forced on populations, leaving those in non-adopting states out of the opportunity to be eligible that Obamacare's answer--TOUGH, the most we'll do is exempt you from the individual mandate tax, (https://www.healthcare.gov/health-coverage-exemptions/exemptions-from-the-fee/).
And the Medicaid EXEMPTION is not the only one that brutalizes arguably the neediest among us. If you're homeless, tough for you (but we won't tax you), if you experienced domestic violence, tough for you (but we won't tax you for not having health insurance), if you filed for bankruptcy, tough for you (but we won't tax you for not having health insurance), if you had medical expenses you couldn't pay, tough for you (but we won't tax you for not having health insurance).
The law is also idiotic--why is domestic violence counseling one of the freebies we must all pay for in every policy when people who are victims of domestic violence are EXEMPT from purchasing health insurance? Or, why can millionaires who can somehow get their INCOME to satisfy eligibility for entitlement money under Obamacare get government money because there is no assets test under Obamacare but the poorest among us can be left without health insurance? This isn't growing pains, it's the stupidity of Obamacare.
Ms. Rosenthal, as an Obamacare apologist, exemplifies the misinformation standard that has been used to push Obamacare, the hard-headed adherence to the original false promises that are divorced from reality. "LABELING" is not the answer to this, meaningful CHANGES to or REPEAL of the law is the answer.
