Whose Credibility Gap?

Did President Obama tell a whopper when he told voters in 2012, “If you like your health plan, you can keep your health care plan”?

The White House clearly knew that some people would lose their health plan, and even though the combination of state-run healthcare exchanges and tax subsidies would offer most a better deal, some insurance customers inevitably would be upset. So the President should have included a disclaimer that “you can keep your insurance unless it is a junk policy that does not meet minimum standards for meaningful coverage of hospitalization or chronic health problems. In that case, no, you won’t be able to let the insurance company swindle you any more.”

A good example of the disclaimered class is Donna Barrette, a 57-year-old Florida real estate agent who was paying $54 a month for Blue Cross insurance. She was upset when she got a letter that her plan would be cancelled as of Jan. 1, 2014. Blue Cross offered a replacement plan at $591 a month, which she said was unaffordable at her salary of $30,000. CBS News depicted her as a typical case of “Obama taking my insurance away.” But other reporters found that Barette could get cheaper plans on the state healthcare exchange, with tax credits paying for nearly $320 a month. And Barrette’s old plan was no bargain, paying only $50 per doctor visit, charging her for tests that can run into hundreds of dollars, $15 per prescription, which barely covers generic drugs, and nothing at all for hospitalization, putting her coverage squarely in the “junk policy” category.

Nancy Metcalf of Consumer Reports found that Humana’s Direct Silver 4600/6300 plan, available in Florida at a cost to Barrette of $165 per month, pays for preventive services, the first $500 of diagnostic lab tests and x-rays per year and 100% of expenses after she spends $6,300.

When Jonathan Cohn of The New Republic told Barrette about her options, she said she would jump at it. “With my age, things can happen. I don’t want to have bills that could make me bankrupt. I don’t want to lose my house.” She added, “Maybe it’s a blessing in disguise.”

Republicans have little room to complain about President Obama’s stretching the truth after the GOP has spent the last four years lying about the Affordable Care Act.

Catharine Richert of Minnesota Public Radio in September listed the “Top 5 myths about ‘Obamacare’ that refuse to die.”

The top myth was that the law creates “death panels.” Former New York Lt. Gov. Betsy McCaughey (R) on July 16, 2009 falsely claimed that the House health care reform bill would “require” end-of-life counseling for seniors to “tell them how to end their life sooner.” Conservative media repeated that claim until Sarah Palin on Aug. 7, 2009, claimed that “my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.”

PolitiFact examined both claims and on Aug. 8, 2009 rated them “Pants on Fire!” “The truth is that the health bill allows Medicare, for the first time, to pay for doctors’ appointments for patients to discuss living wills and other end-of-life issues with their physicians. These types of appointments are completely optional, and AARP supports the measure.” (The claim that ACA included “death panels” was rated by PolitiFact as “Life of the Year” for 2009.)

Those are clearly the facts, but that hasn’t stopped conservative commentators from claiming that Obamacare includes death panels every time a committee meets that is affiliated with Medicare or other health care programs.

The second myth is that the law represents a government takeover of healthcare. What the ACA did was to establish standards for what a health insurance policy must cover, so that patients would not find out after being diagnosed with a serious illness that their insurance didn’t cover it, or that the coverage was severely limited. The law created an online marketplace where consumers and small businesses can shop for health plans — most of them offered by private corporations.

The third myth — that you won’t be able to keep your doctor or your current insurance — is where Obama ran into trouble when he assured Americans that “If you like your insurance, you can keep your insurance.”

For the 87.5% of Americans who get their insurance through their employer or the government, their insurance shouldn’t change, unless employers decide to change the coverage they offer. Nothing in the law requires changes, as long as the policy meets minimum standards.

Richert also noted that if you’re buying insurance through one of the new exchanges, it’s possible you won’t be able to find a plan that includes your current physician. But that’s largely a function of the provider networks insurers choose.

The fourth myth is that ACA covers unauthorized immigrants and abortions. The ACA bars unauthorized immigrants from purchasing insurance through the exchanges, and they cannot obtain Medicare or non-emergency Medicaid coverage. They can get care at the emergency room, but that’s no different from how things already work.

As for abortion coverage, federal funds still can’t be used to cover abortions unless it is a case of rape, incest or the mother’s life is in danger. Insurance companies will retain their current ability to sell plans that cover abortions, Richert wrote, but for people who qualify for federal subsidies, the law includes a mechanism to make sure that aid isn’t used to pay for abortion coverage.

The fifth myth is that the ACA is a “job killer.” Richert noted that claim is based on a mischaracterization of a Congressional Budget Office report that predicted upwards of 800,000 people, who keep their jobs mainly for the health care coverage, would leave the workforce because they would be able to find affordable insurance through the state insurance exchanges. Some of them will be older workers who choose to retire earlier than they otherwise would — which would free jobs for younger people who are looking for work. Some workers will be able to leave their corporate jobs to pursue their own entrepreneurial ambitions. And the National Federation of Independent Business, which has fought the health reform law, recently reported that 7% of its members who now offer insurance plan to drop it, but 13% of those who don’t currently offer insurance plan to add it.

There also have been projections that, with an estimated 32 million Americans gaining health insurance that they would not otherwise have, that increase in demand for services will require hundreds of thousands of new jobs in health care and insurance industries.

So while Obama may have stumbled out of bounds with his promise that people could keep their insurance policies, Republican critics of the Affordable Care Act have repeatedly hit low blows, mischaracterizing the health reform law with a reprehensible disregard for the truth.

Even now, Republicans at the state level have refused to let the working poor get Medicaid coverage for which the federal government is paying nearly the entire cost. They refused to participate in development of the healthcare exchanges and they are even harassing “navigators” who help guide people through their options on the exchanges. In Congress, the Republican-dominated House refused Health and Human Services Secretary Kathleen Sebelius’ request for funds to help implement the program after 36 states ducked their duties. They shut down the government in an attempt to defund the law. And now they are calling Sebelius to their committees so they can complain about the glitchy website.

As the benefits of the Affordable Care Act become recognizable, we think the American people will be more forgiving of President Obama and Secretary Sebelius than they will be of the Republicans who tried to obstruct its passage and then sabotaged its implementation at the state and federal level. — JMC

From The Progressive Populist, December 1, 2013


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