ProPublica Tells The Story Of Loyal Obama Supporters, Canceled by Obamacare

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This article, written by Charles Ornstein, was originally published by ProPublica on Nov. 6.

San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.

Since 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietitian and diabetes educator. “We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.

The couple — Lee, 60, and JoEllen, 59 — have been paying $550 a month for their health coverage — a plan that offers solid coverage, not one of the skimpy plans Obama has criticized. But recently, Kaiser informed them the plan would be canceled at the end of the year because it did not meet the requirements of the Affordable Care Act. The couple would need to find another one. The cost would be around double what they pay now, but the benefits would be worse.

“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.

I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA. In many cases, it turns out, the consumers could have found cheaper coverage through the new health insurance marketplaces, or their plans weren’t very good to begin with. Some didn’t know they could qualify for subsidies that would lower their insurance premiums.

So I tried to find flaws in what Hammack told me. I couldn’t find any.

Hammack recalled his reaction when he and his wife received a letters from Kaiser in September informing him their coverage was being canceled. “I work downstairs and my wife had a clear look of shock on her face,” he said. “Our first reaction was clearly there’s got to be some mistake. This was before the exchanges opened up. We quickly calmed down. We were confident that this would all be straightened out. But it wasn’t.”

I asked Hammack to send me details of his current plan. It carried a $4,000 deductible per person, a $40 copay for doctor visits, a $150 emergency room visit fee and 30 percent coinsurance for hospital stays after the deductible. The out-of-pocket maximum was $5,600.

This plan was ending, Kaiser’s letters told them, because it did not meet the requirements of the Affordable Care Act. “Everything is taken care of,” the letters said. “There’s nothing you need to do.”

The letters said the couple would be enrolled in new Kaiser plans that would cost nearly $1,300 a month for the two of them (more than $15,000 a year).

And for that higher amount, what would they get? A higher deductible ($4,500), a higher out-of-pocket maximum ($6,350), higher hospital costs (40 percent of the cost) and possibly higher costs for doctor visits and drugs.

When they shopped around and looked for a different plan on California’s new health insurance marketplace, Covered California, the cheapest one was $975, with hefty deductibles and copays.

In a speech in Boston last week, President Obama said those receiving cancellation letters didn’t have good insurance. “There are a number of Americans — fewer than 5 percent of Americans — who’ve got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident,” he said.

“Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy. So a lot of people thought they were buying coverage, and it turned out not to be so good.”

What is going on here? Kaiser isn’t a “bad apple” insurer and this plan wasn’t “cut rate.” It seems like this is a lose-lose for the Hammacks (and a friend featured in a report last month by the public radio station KQED.)

I called Kaiser Permanente and spoke to spokesman Chris Stenrud, who used to work for the U.S. Department of Health and Human Services. He told me that this was indeed a good plan. Patients in the plan, known as 40/4000, were remarkably healthy, had low medical costs and had not seen their premiums increase in years. “Our actuaries still aren’t entirely sure why that was,” he said.

While many other insurance companies offered skimpier benefits, Stenrud said, “our plans historically have been comprehensive.”

Kaiser has canceled about 160,000 policies in California, and about one third of people were in plans like Hammack’s, Stenrud said. About 30,000 to 35,000 were in his specific plan.

“In a few cases, we are able to find coverage for them that is less expensive, but in most cases, we’re not because, in sort of pure economic terms, they are people who benefited from the current system … Now that the market rules are changing, there will be different people who benefit and different people who don’t.”

“There’s an aspect of market disruption here that I think was not clear to people,” Stenrud acknowledged. “In many respects it has been theory rather than practice for the first three years of the law; folks are seeing the breadth of change that we’re talking about here.”

That’s little comfort to Hammack. He’s written to California’s senators and his representative, House Minority Leader Nancy Pelosi, D-Calif., asking for help.

“We believe that the Act is good for health care, the economy, & the future of our nation. However, ACA options for middle income individuals ages 59 & 60 are unaffordable. We’re learning that many others are similarly affected. In that spirit we ask that you fix this, for all of our sakes,” he and Brothers wrote.

Consumer advocate Anthony Wright said it’s important to remember the way the insurance market worked before the act was passed, when insurers could deny coverage based on pre-existing conditions. “It’s impossible to know what the world would have looked like for these folks in the absence of the law,” said Wright, executive director of the group Health Access.

“We certainly had an individual market, especially in California which was the Wild Wild West, where there was huge price increases, cancellations, a range of other practices.

“That doesn’t mean that there were certain people who lucked out in the old system, who wound up in a group with a relatively healthy risk mix and thus lower premiums,” he added. “The question is: Is health insurance something where people get a rate based on the luck of the draw or do we have something where we have some standards where people who live in the same community, of the same age, with the same benefit package are treated equally?”

Wright said discussions should focus on how to provide consumers like Hammack with assistance if they barely miss qualifying for subsidies.

So what is Hammack going to do? If his income were to fall below four times the federal poverty level, or about $62,000 for a family of two, he would qualify for subsidies that could lower his premium cost to as low as zero. If he makes even one dollar more, he gets nothing.

That’s what he’s leaning toward — lowering his salary or shifting more money toward a retirement account and applying for a subsidy.

“We’re not changing our views because of this situation, but it hurt to hear Obama saying, just the other day, that if our plan has been dropped it’s because it wasn’t any good, and our costs would go up only slightly,” he said. “We’re gratified that the press is on the case, but frustrated that the stewards of the ACA don’t seem to have heard.”

Like this story by health care reporter Charles Ornstein? You may also want to read “Why Health Insurance Cancellations Shouldn’t Be a Surprise” and “The Affordable Care Act’s Most Important Date: Not What You Think.”

 

Personal Liberty

ProPublica

is an independent, non-profit newsroom that produces investigative journalism in the public interest. The organization’s work focuses exclusively on truly important stories, stories with “moral force.” ProPublica seeks to produce journalism that shines a light on exploitation of the weak by the strong and on the failures of those with power to vindicate the trust placed in them. ProPublica is headquartered in Manhattan. Its establishment was announced in October 2007. Operations commenced in January 2008, and publishing began in June 2008. http://www.propublica.org/

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  • JimH

    They voted for exactly what they got.

    • podunk1

      Wonder if they’ll blame God or Obombster if they break a leg, go to an obummer hospital, & wake up with a sex change, & an artificial knee implant half way between ankle & the other knee?

      • JimH

        Bush and the Tea Party. Maybe Ted Cruz.

  • dontdoitagain

    Yup, no sympathy here.

  • Muffin Man Mashinksy

    H AHAHAHA!!!! I think anyone who voted for this bum & believed him should get coverage for mental illness as well!!

    Ah, Divine Justice is sooooooooo sweet!!!

  • Oldmonkey

    Caught in a web of bad Karma for supporting others taking what’s not theirs, they find themselves a victim. Hopefully those like them will also be victims too.

  • Bill

    You make your own bed and you sleep in it

  • Warrior

    Ah Lee and JoBell, fear not, you did the wise thing by dropping queen nan a note. Enjoy your “exemption”. Oh, and do not forget to send “nan” a donation. She’ll really appreciate it!

    • Muffin Man Mashinksy

      Hey, Lee & Cracked Bell……NOW YOU KNOW WHAT’S IN IT, RIGHT?…..And these LOONY TUNES LIBs still say they stand by Obummer & the other DEMs & their agenda……LMAO!!!,,,,Yeah, PE-LOUSY will help you……………HAHAHAHAHA!!! Obummer & the DEMs do not give a rat’s arse about or anyone else!!

  • Sharon Jeanguenat

    I’m going to say, ‘Told you so, you idiots!’ Now deal with it!

  • Cliffystones

    Another couple of aging, reefer-addict, hippies who are getting exactly what they deserve!

  • http://seekingalpha.com/article/1514632 lottopol

    Everyone whose policy was
    “cancelled” has been offered better plans. Should people who like to
    buy cars without any safety features, no seat belts, no airbags, no horn, no
    brake lights etc. be allowed to buy those cars? Safety features add at least
    $1,000 to the cost of a car. Some people might like to buy cars without safety
    features and everyone would like to pay $1,000+ less for a car. However, we do
    not allow cars to be sold without safety features.

    The 75% of those in the USA who file for bankruptcy because of unpaid medical
    bills who HAD insurance, probably now would say they wish that those policies
    with low lifetime caps (now illegal) should not have been allowed to be sold to
    them.

    Does anyone doubt that if Obama had been
    politically savvy enough to allow all people with existing policies no matter
    how bad or inadequate to keep those policies, the Republicans would now be
    saying: 1 Obama said the people would not lose their insurance because of
    preexisting conditions and now he is allowing those policies to continue and/or
    2. Obama is forcing private insurance companies to continue selling policies
    that they might not want to sell because such policies expose them to lawsuits.

    Do you think people should be allowed to
    buy cars without any safety features, no seat belts,
    no airbags, no horn, no brake lights etc.? Yes or no? If there was no
    mandate to buy insurance, would you favor allowing people to buy insurance that
    was going to be cancelled as soon as they got sick? Yes or no? How about
    tainted food. You don’t have to buy meat, should you be able to buy meet with
    salmonella in it?

    Under the present system anyone who applies
    for private health insurance must submit detailed medical information and
    consent to having any doctor you ever used providing all of you files to the
    insurance company. THEN all of your medical information is forwarded to ,MIB Group, Inc (formerly
    The Medical Information Bureau Inc.) which operates a database
    of medical
    information on individuals who have
    previously applied for health insurance,
    Any insurance company, and thus any employees of any insurance company which is
    a member of the MIB can access all of the medical records on anyone who has
    ever applied for health insurance. Under Obamacare medical underwriting which
    screens out people with preexisting conditions is not allowed so health insurance
    companies have no reason to ask medical questions and can no longer access you
    medical records.

    Switzerland is one of the most conservative
    pro-business anti-tax countries in the world. It is illegal for a Swiss bank to
    provide information to a tax authority including the Swiss Government. Adult
    male homeowners in Switzerland are required by law to have fire arms in their
    homes and if a homeowner requests it, the Swiss government will give the homeowner
    a heavy machine gun. (one of the reasons Hitler did not invade Switzerland during
    World War II). Even Switzerland had to abandon market-priced healthcare.

    “..The USA
    is the last holdout with market-priced medical care not because of any inherent
    conservative or free market ideology. Rather, as the wealthiest nation that
    ever existed we are the last ones who can afford it. Switzerland was one of the last advanced economies to abandon market-priced medical care. It is arguably a greater bastion of conservatism than the USA. Switzerland’s women were not granted the right to vote until 1971…”

    http://seekingalpha.com/article/1647632

    • lakeside227

      Did you even read the article?

    • garygerke

      Seekingalpha is a joke!!!!!!!!!!!!

    • Ringgo1

      Leftist propaganda spewing TROLL!

    • Robert Messmer

      You say, “Everyone whose policy was “cancelled” has been offered better plans”. Prove it.

      Yes they should be allowed to buy cars without seatbelts and airbags because the government has no business micro-managing the daily lives of citizens. Little matter of certain inalienable rights. The lack of seatbelts and airbags affect no one except those who choose to forgo them, therefor is not an issue government need be concerned with.

      “The 75% of those in the USA who file for bankruptcy because of unpaid medical bills who HAD insurance” means nothing without knowing how many filed for bankruptcy because of unpaid medical bills. Please document that the filing was predicated simply on unpaid medical bills and not on other unpaid bills which they then decided to list the medical bills as well. What would the other 25% say?

      You are saying that Obama is not politically savvy enough and that excuses and justifies his out right lies to America?

      Besides the fact that premiums will cost more, deductibles will be higher, co-pays will be higher what makes you think that insurance companies won’t cancel policies when people get sick? Because Obama told us they wouldn’t? See above about his lies.

      Since the USDA (another government job like ACA) doesn’t do the job it is supposed to be doing, people DO buy meat and other food items with salmonella in it. Then after enough people have gotten sick they recall the tainted food.

      “Under Obamacare medical underwriting which screens out people with preexisting conditions is not allowed so health insurance
      companies have no reason to ask medical questions and can no longer access you medical records.” So you saying that Obama sent the EPA swat team in to MIB Group, Inc., seized all the hard drives, paperwork, etc and destroyed it all. Cause if the data base still exists it can and will be accessed.

      Switzerland makes very good chocolate. It may be illegal but Swiss banks co-operated with Eric Holder and turned over information on American customers so you may wish to omit that statement in your next copy and post. Up to 1971 they probably had very sensible elections. Anti-tax and pro-gun–two qualities of the Swiss that Obama should have imitated instead of their Socialist health policy.

      • Motov

        Government is not satisfied until they can completely invade our privacy. I worry about their idea of putting in “black boxes” into cars that collect data so they can monitor your every move, where you have driven, how fast you drive, I bet they will even have the ability to kill your car if they feel like stopping you to perform search and seizures. Nanny state of the art harassment.

      • http://seekingalpha.com/article/1514632 lottopol

        >>>Yes they should be allowed to buy cars without seatbelts and airbags because the government has no business micro-managing the daily lives of citizens. Little matter of certain inalienable rights.>>>
        At least you are conistent. How about selling meat with botulis or samonella in it. Your right to feed poison to your children or sell tainted meat to other poeples’ children also a “Little matter of certain inalienable rights.” How about builings with out fire and safety codes?
        BTW Swiss banks co-operated with Eric Holder and turned over information on American customers only after the USA threatened to put major Swiss banks like CS and UBS out of business by revoking their American banking licenses. That in no way negates the argument that the Swiss are very conservative and rich and still had to abandon market-priced health care.

        • Robert Messmer

          As to your silliness about selling poisoned meat and “little matter of certain inalienable rights” I never claimed that harming others are protected as part of those rights.

          While I agree it would have put a crimp into their operations, I doubt that it would have put “major Swiss banks…out of business”. If it is really illegal as you say then what jail sentences did the bankers receive for violating the law and reporting their customers business to Holder? Yes, Switzerland is conservative, rich, makes very good chocolate — and what foreign governments do is not necessarily what we should do. Since you are so in favor of following the Swiss, at least since you brought them up as a fine example, have you contacted your Representatives and Senators and suggested that we should also follow the Swiss in the law about every household had to have weapons?

          Have to give you credit for being consistent in ignoring the actual conversation and being able to provide any objective proof to back up your statements.

          • http://seekingalpha.com/article/1514632 lottopol

            It is illegal under Swiss law for the banks to divulge information to the tax authorities. Under pressure from Holder and thus from the major Swiss banks who were faced with the prospect of losing American licenses, the Swiss government administration signed an agreement granting an exception allowing some Swiss banks to provide information to the US tax authorities. However, just like various treaties the President of the USA signs, the agreement does not take effect until it is ratified by the Swiss parliament, which so far has refused to do so. Holder has put of prosecuting the banks while the Swiss government administration attempts to must the votes to pass the treaty.

            The only reason why Switzerland is relevant to the discussion is that every single developed country in the except the USA, but including richer and more conservative Switzerland, controls health care prices and thus spends less that half as much a the USA on health care as a percent of GDP.

            “..Adopting the second worst healthcare system in the world, Canada, Germany and the UK are probable the
            best candidates for that dubious honor, would allow the USA to eliminate much of the Federal budget deficit. Being the second worst healthcare system after the USA, is like being the second worst nuclear accident in the last decade after Fukushima. There probably was another nuclear accident where a few people were injured in the last decade, but none comes to mind immediately…”
            http://seekingalpha.com/article/1647632

          • Robert Messmer

            “Communism which once prevailed in the entire “second world” persists today only in North Korea and Cuba.”

            Since I haven’t seen any free and democratic elections being held in Red China your link is a little suspect since it excludes the 3rd largest country in the world with a population in excess of one billion as being a communist country. And that error is in the very first sentence.

  • Quester55

    My Heart Breaks for my Brother’s & Sisters that Voted for this two-legged Dung Pile, & I really hope they can Finally see just how greatly they ALL have been Suckered in to believing what a good man he is!
    Many of my race are Fainting, when they awake from their OBAMA INDUCED SLUMBERS! It’s Hard to Chock down that CROW you-all are eating, However, You where warned & you choose Not to Listen !
    Wake Up, Though the OLD Democratic Party was once a Good Party, That Party was over the night that they Choose to Assassinate J.F.K.!
    Your Sitting with a New Muslim Controlled, Anti-God, Party that would rather see you all in CHAINS Again, Working in the Fields!

  • Erik Lee

    Warms my heart to see old hippie socialists take one for the team.

  • garygerke

    These people are the blind lemmings that elect, and keep electing the Obama’s and the Pelosi’s. Now that their blind faith in the Democratic party has effected them, they do not like it and ask help from the very people that caused the problem! “YOU HAVE TO PASS IT TO FIND OUT WHAT’S IN IT”!!!!!!

    • Mole Johnson

      Lots of people are starting to find out whats in it ….

  • stopspending4

    Note that they still have not changed their opinion of O. Typical left, they want to help the “less fortunate” with the “rich” people’s money but when they find out they are the “rich” they want an exemption. They meant for it to be the other “rich” people’s money, not theirs.

    • Motov

      Typical libtard thinking, always they know how to spend your money, but don’t you DARE take from his back pocket!!

      I heard years ago (I bet it is still true) True conservatives generally spend more money to charitable causes than liberals do, and the charities they choose to spend, put more money to the actual cause than “charities” that makes certain their CEO’s are well cared for.

  • Gary

    Sorry, when you create a healthcare scheme where 40 million uninsured are magically going to have health insurance, where pre-existing conditions can not be denied or even pay higher premiums, where kids can stay on their parents’ plan until 26, this is what happens. The math does not add up! Unfortunately, no matter how well-intentioned or wonderful in theory universal healthcare is, it still has to stand up to arithmetic. There is no way any of the above can happen without most people (unless you are a perpetual “taker” from the gubment) paying more. And no liberal fantasy-land can stop that.

  • Mole Johnson

    Well, isn’t that just too bad. I hope a lot more of them get thrown under the bus by their wonderful … ahem … president.

  • Peggy

    Well, it is about time you woke up and smelled the roses. Welcome to our world, and glad you finally have your blinders off.