Read it in full — and do not quit before the end or else you’ll miss the most important part. A simple premise from Pro Publica: Let’s take an ObamaCare “sob story” from someone whose plan just got canceled and give it a thorough fact-checking to see if it’s as bad as they say. Sure, their new coverage is expensive, but maybe they qualify for subsidies and don’t even realize it. Sure, their new plan isn’t that great, but maybe their old plan really was one of those “cut-rate” garbage plans that fly-by-night insurers have been peddling to people for years. They only think they’re getting hosed.
Nope. After the fact check, it’s clear: They got hosed.
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 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.
As I say, read to the end for the ominous conclusion, in which Hammack contemplates how he might qualify for subsidies. Not only was their old plan not cut-rate, it was “comprehensive” just like all the new ObamaCare exchange plans are required to be. Turns out Hammack and his wife lead a healthy lifestyle and had qualified for a solid plan with low premiums for years because of it. That makes them the perfect target for O-Care: One of the key ways that coverage for people with preexisting conditions will be subsidized is by gouging healthy people with expensive new “comprehensive” plans that they won’t much use. Their premiums are almost pure net gain for insurers and that gain can be applied to offset the losses they’re taking from the sick. In any redistributive scheme, there are winners and losers; these people, to their great surprise, ended up as losers for having committed the sin of taking good care of themselves for a long time. The spokesman for Kaiser Permanente, Hammack’s former insurer, made no bones about that either in speaking to Pro Publica: “[I]n 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.” And like I said Monday, I don’t think rate shock is even the biggest political landmine in all this. The big landmine will go off when people realize they’re not only paying more, they’re getting a smaller provider network in their new “comprehensive” plan despite the added expense. Pro Publica doesn’t get into that in its story about Hammack; I look forward to the sequel.
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