Following the October 1 rollout of the Affordable Care Act's exchanges, media outlets hyped several anecdotal stories of people who will be negatively affected by the law. These stories have ranged from the misleading to the outright false.
Media “Horror Stories” Conflict With Reality
MYTH: ACA Caused Cancer Patient To Lose Her Coverage. In a Wall Street Journal op-ed, cancer patient Edie Littlefield Sundby blamed the ACA for the loss of her coverage, calling herself “one of the losers” of the health care law:
For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.
My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.
Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state's Affordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed. [The Wall Street Journal, 11/3/13]
REALITY: Sundby's Coverage Is Being Dropped Because Her Insurer Did Not Want To Pay For Sicker Patients. In a ThinkProgress post, Igor Volsky pointed out that Sundby's dropped coverage is a result of her insurer, United Healthcare, being unwilling to insure sicker patients:
But Sundby shouldn't blame reform -- United Healthcare dropped her coverage because they've 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. “Over the years, it has become more difficult to administer these plans in a cost-effective way for our members,” UnitedHealth spokeswoman Cheryl Randolph explained. “We will continue to keep a major presence in California, focusing instead on large and small employers.” [Think Progress, 11/4/13]
MYTH: Obamacare Caused Businessman To Cut Back On Employment. On the October 11 edition of Fox News' Hannity ¸ host Sean Hannity interviewed Paul and Michelle Cox, business owners who claimed that ACA regulations were causing them to “cut back on hiring full-time employees” and “keep [employees] below 30 hours” :
MICHELLE COX: We received a letter from our insurance company stating that we would no longer be able to have our existing health plan, despite the president's promise that we would be able to keep that existing plan.
As a business, we are jumping through more hoops, more regulation, more paperwork. And we've also cut back on hiring full-time employees because of the health care costs involved, even though we'd love to do that.
HANNITY: You'd like to hire full-time employees --
MICHELLE COX: We would love to.
HANNITY: -- but you -- so you're going to keep them below 30 hours.
MICHELLE COX: Exactly.
PAUL COX: We've had to keep them below 30 hours or we wouldn't be able to -- you know, not that we wouldn't want to pay it, we just wouldn't be able to --
MICHELLE COX: Yes.
PAUL COX: -- stay in business and pay it. [Fox News, Hannity, 10/11/13]
REALITY: Cox's Business Has Only Four Employees And Not Subject To ACA Regulations. In an October 18 Salon post, Eric Stern, a senior counsel to former Montana Gov. Brian Schweitzer, contacted Paul Cox after the segment and found that his business employed only four people, well below the 49-employee threshold that would have affected his business:
First I spoke with Paul Cox of Leicester, N.C. He and his wife Michelle had lamented to Hannity that because of Obamacare, they can't grow their construction business and they have kept their employees below a certain number of hours, so that they are part-timers.
Obamacare has no effect on businesses with 49 employees or less. But in our brief conversation on the phone, Paul revealed that he has only four employees. Why the cutback on his workforce? “Well,” he said, “I haven't been forced to do so, it's just that I've chosen to do so. I have to deal with increased costs.” What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he'd call me back. He never did.
There is only one Obamacare requirement that applies to a company of this size: workers must be notified of the existence of the “healthcare.gov” website, the insurance exchange. That's all. [Salon, 10/18/13]
MYTH: ACA Caused Family's Premiums To Double. Hannity's October 11 show also featured Allison and Curt De Nijs, a couple who claimed their existing health care plan was being cancelled and their new health insurance policy would double:
ALLISON DE NIJS: Well, we became self-employed three years ago. And over the course of three years, our insurance has jumped 49 percent. We just got our letter from our insurance carrier that our policy is going to be terminated, and we're going to be transitioned to an ACA-compliant policy because it has to include essential health care benefits.
ALLISON DE NIJS: And we don't even have insurance for our daughter, who has a pre-existing condition. So we're looking at probably $20,000 in premiums next year.
HANNITY: Up from?
ALLISON DE NIJS: Up from -- well, originally, it started out at about $740 and going up to $1,105 next year.
ALLISON DE NIJS: And plus our daughter's going to be about $600 a month.
HANNITY: So you're going to pay 13 -- 19,000 grand a year in health insurance, between you -- just you guys and your daughter, $19,000?
ALLISON DE NIJS: Yes.
HANNITY: Which is how much higher than what it was? Twice as high?
CURT DE NIJS: Twice as high. [Fox News, Hannity, 10/11/13]
REALITY: The Couple Had Not Compared ACA Plan Pricing And Would Likely Save Money On The Exchange. Salon's Stern also contacted Allison De Nijs, who admitted that she had not shopped on the exchange. After researching their situation, Stern found that the couple would save 60% on their health care costs:
I asked Allison if she'd shopped on the exchange, to see what a plan might cost under the new law. She said she hadn't done so because she'd heard the website was not working. Would she try it out when it's up and running? Perhaps, she said. She told me she has long opposed Obamacare, and that the president should have focused on tort reform as a solution to bringing down the price of healthcare.
I tried an experiment and shopped on the exchange for Allison and Kurt. Assuming they don't smoke and have a household income too high to be eligible for subsidies, I found that they would be able to get a plan for around $7,600, which would include coverage for their uninsured daughter. This would be about a 60 percent reduction from what they would have to pay on the pre-Obamacare market. [Salon, 10/18/13]
MYTH: ACA Caused Couple's Premiums To Increase By 50 To 72 Percent. Hannity also hosted Robbie and Tina Robinson, who claimed that their plan was being canceled and similar coverage would increase their policy's cost by 50 to 72 percent:
ROBBIE ROBINSON: Well, Sean, I've been -- I've been self-employed for 20 years and --
ROBBIE ROBINSON: But for about 20 years now. And recently, we heard from our insurance provider that our current policy will be canceled, no longer available when it ends. And our new policy that we can have won't have the same benefits to it. Anything similar, though, is going to rise between, like, 50 to 72 percent, and it'll have things in it that we have no choice. Like, we'll have to have maternity benefits. And we're not planning on having any more kids.
ROBBIE ROBINSON: And we're going to have to have pediatric eye care and other things like that, and we -- our kids are all away from home.
ROBBIE ROBINSON: So...
HANNITY: So it's not -- it's not -- it's not a plan that you need.
ROBBIE ROBINSON: Exactly. [Fox News, Hannity, 10/11/13]
REALITY: The Robinsons Could Access Coverage For 63 Percent Less Under ACA Exchanges. Stern contacted the Robinsons and found that they hadn't shopped for coverage on the exchanges, where they could have accessed a policy that would cost 63 percent less than their current plan:
When I spoke to Robbie, he said he and Tina have been paying a little over $800 a month for their plan, about $10,000 a year. And the ACA-compliant policy that will cost 50-75 percent more? They said this information was related to them by their insurance agent.
Had they shopped on the exchange yet, I asked? No, Tina said, nor would they. They oppose Obamacare and want nothing to do with it. Fair enough, but they should know that I found a plan for them for, at most, $3,700 a year, 63 percent less than their current bill. It might cover things that they don't need, but so does every insurance policy. [Salon, 10/18/13]
MYTH: ACA Would Have Replaced Woman's Adequate Coverage With A Much More Expensive Plan. CBS This Morning highlighted Dianne Barrette as an example of someone who is losing coverage because of the ACA:
In California, Kaiser Permanente terminated policies for 160,000 people. In Florida, at least 300,000 people are losing coverage.
That includes 56-year-old Dianne Barrette. Last month, she received a letter from Blue Cross Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she's being offered would run $591 a month -- 10 times more than what she currently pays.
Barrette said, “What I have right now is what I am happy with and I just want to know why I can't keep what I have. Why do I have to be forced into something else?” [CBS, CBS This Morning, 10/28/13]
REALITY: Barrette's Plan Could Have Bankrupted Her With Any Hospitalization. On his Washington Post blog, Erik Wemple noted that Barrette's existing coverage would not have covered hospitalization and “could well have bankrupted” her:
More coverage may provide a deeper understanding of the ins and outs of Barrette's situation: Her current health insurance plan, she says, doesn't cover “extended hospital stays; it's not designed for that,” says Barrette. Well, does it cover any hospitalization? “Outpatient only,” responds Barrette. Nor does it cover ambulance service and some prenatal care. On the other hand, says Barrette, it does cover “most of my generic drugs that I need” and there's a $50 co-pay for doctors' appointments. “It's all I could afford right now,” says Barrette.
In sum, it's a pray-that-you-don't-really-get-sick “plan.” When asked if she ever required hospitalization, Barrette says she did. It happened when she was employed by Raytheon, which provided “excellent benefits.” Ever since she left the company and started working as an independent contractor, “I haven't been hospitalized since then, thank God.” Hospitalization is among the core requirements for health-care plans under Obamacare. [The Washington Post, Erik Wemple Blog, 10/28/13]