When I discussed the issue of people being dropped from their insurance plans last week I concentrated on how what was occurring differed from the more sensationalistic reports. The Republicans, in a typical display of hypocrisy and dishonesty, have successfully turned this into a question of Barack Obama’s honesty. While Obama has made several statements, including on this topic, which I would have preferred he had not made, it has been the Republicans who have been far more dishonest in the health care debate.
When I wrote the prior post I initially, for the sake of simplicity, left out a key factor of insurance companies being able to continue old plans and grandfather people into previous plans, provided that they met some basic levels of coverage. This made it possible for Obama to see it as honest to claim that if people liked their current plan they could keep it. On one level it may be true for the Obama administration to argue that the Affordable Care Act does not require that insurance companies drop all of the people who are receiving notices of being dropped. However, this is certainly misleading as it was predictable that insurance companies would prefer to end many of the old plans and move subscribers into he newer products which they will actually be selling. This was actually discussed at the time, but many people just heard the briefer, but misleading, statements as opposed to looking into the details.
This problem only applies to a small percentage of the population who purchase insurance coverage on the individual market. This does not mean that such people would lose all insurance coverage. Insurance companies which drop people from a plan which is no longer being offered are required to offer a replacement plan. Many people will receive new plans, with more comprehensive coverage, at a lower price due to the subsidies. Many of the old plans covered very little, and many people will come out ahead financially because of lower out-of-pocket medical expenses. Replacing plans with limited coverage, such as not covering hospitalizations or having a ridiculously low cap on total coverage, is actually a benefit of the Affordable Care Act.
There are also losers in the deal, including myself. Lower income people will receive subsidies, in some cases covering the entire cost of insurance. Those with higher incomes who do not qualify for subsidies may or may not come out behind, depending upon how much money the new policies save in out-of-pocket medical costs. There are other variables. People living in larger cities are likely to have more insurance companies competing for their business, which might keep costs lower. Older individuals are more likely to see higher premiums, while those under thirty will have lower premiums and also have the option of low cost catastrophic plans.
While I estimate that I will be spending at least a few thousand dollars more a year on health insurance than previously (and again, keep in mind that those with lower incomes will not see this increase) there are still benefits. While I may or may not be interested in paying more, the newer policies are more comprehensive than what was available on the individual market when I purchased my current policy. Even if I have no need for the more comprehensive insurance (and nobody knows for sure how much insurance they will need in the future), there is one key benefit. That is the knowledge that, regardless of how my health is in the future, the new policies cannot be cancelled and insurance companies cannot jack up the price to get rid of people who become expensive to cover. In the past, bankruptcy due to medical costs was a tremendous problem, even among those who started out with insurance before developing a catastrophic illness.
I do wish the Obama administration had been clearer on this point. It is somewhat understandable that they would want to stress the fact that most people will keep their current plans in an atmosphere where Republicans were spreading scare stories that they would be moved into a government-run health care plan. People can continue to have private insurance, with the same company if desired. However there is a relatively small, but not insignificant, number of people purchasing coverage on the individual market who will be forced to purchase a different and more expensive plan.
In an ideal world, government leaders would avoid such overly-simplified statements where there are exceptions which make the statement untrue. The Obama administration is now learning the price of taking such short cuts. However, as it is the Republicans who want to make this a debate over honesty, any dishonesty on the part of Obama is far less significant to that of Republicans who spread outright lies about death panels and a government takeover of health care. This is also trivial compared to the dishonesty seen by George W. Bush when he promoted the Medicare D plan–threatening to fire the chief Medicare actuary if he testified before Congress as to the true cost of the plan. (Of course Bush’s lies about his Medicare D plan were also trivial compared to taking the country to war based upon false claims of WMD in Iraq).
It was foolish of Obama to make such an absolute claim as he did in a situation where there are some exceptions. Besides being ethically questionable, regardless of whether the Republicans are telling much bigger lies, it was predictable that it would lead to unfortunate consequences. The Republicans are just so much better at spreading lies, and have many friends in the broadcast and cable news media who will repeat repeat their lies without questioning them.
What is especially hypocritical about the Republican stand is that they are trying to portray themselves as protecting people from losing their insurance plans. In reality, the Republicans support policies which would return to the old status quo where insurance companies could, and often did, stop covering people based upon financial incentives. The Republicans are waging a campaign to sabotage Obamacare, which would leave many people without any insurance coverage whatsoever.
While the Republicans are now acting as if they are trying to protect people from higher health care insurance costs, the reality is that their plans would leave people paying more for health care out of their pockets. Republicans also opposed proposals when the Affordable Care Act was being considered, such as the public option, which would have done more to keep costs down. Maybe the Affordable Care Act should have been different so as to allow the option of less comprehensive but less expensive plans. If this is what Republicans wanted, they should have debated this when the Affordable Care Act was before Congress. Instead Republicans ignored their responsibilities as legislators, vowing to vote against any form of health care reform promoted by Democrats. If they are unhappy about the outcome, they should have participated responsibly in the process. They certainly could have bargained to obtain changes in the law in return for a measure of bipartisan support in Congress.
The Republicans will continue to try to sabotage health care reform and claim that any problem with insurance is the fault of Obamacare. We saw that today with The Wall Street Journal blaming Obamacare for a cancer patient losing her insurance plan and, they claim, current doctor when actually this was a consequence of the same types of market forces in the individual market which we have experienced for years. The difference is that in the past, if such a cancer patient was dropped form her plan (as often did occur) she might not have been able to replace it with another plan. Under the Affordable Care Act, she cannot be denied medical insurance, or be charged more, because she has cancer.
We can expect many more scare stories like this, and lies, from the Republicans.