11/15/13

Why the ACA Fixes (even Obama's) are No Fix

Cartoon by Tom Tomorrow, 9/30/13  "Tea Party Freedom Fighters."

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Amid the continuing frenzy to discredit it and dismantle the Affordable Care Act (ACA, AKA Obamacare), I had until now decided not to write on the topic. I am one of those who thinks the act didn't go far enough and yet recognizes that it's better than nothing.   Then this week I read misinformation being spread by a woman I know and respect, whom I suspect is one of those cancelled. And yesterday, the President retrenched yet again.  Today, the House passed Fred Upton's "fix."

Let me tell you, sister, just because you weren't screwed by your insurance company in the past and want to keep a substandard policy, doesn't mean it's a good idea to let the insurance industry blackmail the President.  They are screwing you now and without the ACA they would be completely free to do so in the future.  Or as Ana Marie Cox has already written in The Guardian,

The junk plans the companies offered did not come into existence because they were interested the long-term well-being of the clients. Those plans were the product of a rigged game that allowed insurance company to exclude for the sick and high-risk from more reasonable policies.
I can tell you this from my experience with Blue Cross Blue Shield (now Anthem since changing its status from non-profit to for profit.)  I was first covered by my father's federal Blue Cross Blue Shield policy, then by a BCBS State Employee policy and then by a BCBS large group policy. When I became Executive Director of a non-profit, I chose the BCBS small group plan for our whole workforce as the best available.  Despite such "brand loyalty"  I received no special protection.  Each time I had to qualify and have my premium determined anew.  When I lost my job,  the BCBS COBRA policy amounted to extortion.  As a "Healthy Virginian," I qualified for a comprehensive, affordable individual BCBS policy--albeit with a large deductible--that couldn't be cancelled until I reached a ceiling.

But then I used the insurance and thus had a pre-existing condition. Instead of cancelling, Anthem, over the years, quintupled the price, while offering identical policies to the new suckers at close to my original premium.  If I wanted to take advantage of the "bargain" I could quit my current plan (and its protections). So as "my" policy premium went up, those who hadn't used their insurance yet switched to the "new" identical policy, which left "my" pool sicker and sicker, thus justifying the huge premium.  If this were too much of a burden, Anthem, "helpfully" offered to switch me to a junk plan.

Let me add, that in doing research, I've learned that those "healthy" folks who got sick enough to qualify for medicare disability insurance, but elected to keep their policy to protect their assets, often got nothing for their premiums.  Although they paid the premium for primary insurance, once they received Medicare, Anthem became secondary.  Oh, and a disability policy from Anthem cost quintuple the regular medicare policy, even if the disability required no additional medical treatment, but just made it hard or impossible to work.

Make no mistake, those ACA critics who shut down the government and are now proposing fixes, want to fix nothing: they want to kill the ACA before it can take effect. Because, as bad as the ACA may be (as a result of pandering to the industry), it IS better than nothing. And once US citizens get a taste of some improvement, they might want a real fix.