Welcome to Bizarro Amerika!

The Wall Street Journal published a provocative piece today that seemed as if it had been designed in a lab by Republicans to condemn health care reform. The headline reads, “You Also Can’t Keep Your Doctor,” with a subhead that adds, “I had great cancer doctors and health insurance. My plan was cancelled. Now I worry how long I’ll live.”

 

On cue, the right quickly decided this is the single most important op-ed in the world. And frankly, at a surface level, it’s hard to blame them – the piece tells the story of a cancer survivor named Edie Littlefield Sundby, whose insurer, United Healthcare, is poised to end her coverage, pull out of the individual market, and direct Sundby into an exchange where she’ll have new coverage and a new physician.

 

Naturally, the writer blames the White House and the Affordable Care Act for ending her “world-class health plan.” One of the right-wing bloggers highlighting the op-ed suggested Obama is effectively delivering a “death sentence” to this woman who’s fought stage-4 gallbladder cancer for years.

 

But as is usually the case in situations like these, the closer one looks at the relevant details, the weaker the potency of the political attack. In this case, Sundby isn’t losing out because of “Obamacare”; she’s in a bind because her insurer made a business decision. As Igor Volsky explained, United Healthcare dropped her plan because it’s “struggled to compete in California’s individual health care market for years and didn’t want to pay for sicker patients like Sundby.”


The company, which only had 8,000 individual policy holders in California out of the two million who participate in the market, announced (along with a second insurer, Aetna) that it would be pulling out of the individual market in May. The company could not compete with Anthem Blue Cross, Blue Shield of California and Kaiser Permanente, who control more than 80 percent of the individual market. […]

 

“The company’s plans reflect its concern that the first wave of newly insured customers under the law may be the costliest,” [United Healthcare] Chief Executive Officer Stephen Helmsley told investors last October.

This explanation should raise a few eyebrows among those who desperate to blame the president, Democrats, or the law itself. Volsky added, “The company packed its bags and dumped its beneficiaries because it wants its competitors to swallow the first wave of sicker enrollees only to re-enter the market later and profit from the healthy people who still haven’t signed up for coverage.”

 

If conservatives want to complain about a private insurer prioritizing profit margins, we can certainly have that conversation. If the right wants to explore private insurers preying on public anxiety and confusion to scare people, we can talk about that, too.

 

But in Sundby’s case, the issue is profit margins, not politics. The right is eager to point fingers, but if they’re looking at the president, they’re pointing in the wrong direction.

he policy Barrette has today is called the Go Blue Plan 91. It is not what most people would consider real insurance. Its coverage of doctor visits and tests, such as MRI scans, consists of paying $50 and then letting Barrette pay the remaining balance. Drug coverage works more or less in the same way, only the plan pays $15 per prescription—which is enough to cover generics, but not many name-brands. And hospitalization? The plan pays nothing at all. As Wemple put it, "it’s a pray-that-you-don’t-really-get-sick 'plan.'" Barrette doesn't really disagree—but this plan, she says, was all she could afford. "Most everyone I talked to said they were paying thousands more to get hospital coverage," she told me, "so I took my chances with what I have now."

OK, but what can she get from Obamacare? Using plan data provided to me by the Kaiser Family Foundation, residents of Polk County, Florida have dozens of insurance options from which to choose. The cheapest option for somebody of Barrette's age has premiums of $440 a month, the most expensive goes for $914 a month. But Barrette wouldn’t pay those prices. Obamacare offers tax credits to people with incomes of up to four times the poverty line, or about $45,000 for an individual. Given Barrette’s income, she’ll be getting a tax credit worth nearly $331 a month, according to the Kaiser Foundation’s subsidy calculator. And that tax credit works like a discount, upfront. To figure out what she’d pay, you subtract the value of the tax credit from the price of the plan.