Saturday, November 09, 2013


An always relevant song by David Frishberg (see an earlier post about him HERE). The song came to mind when I heard a brief discussion on the radio the other day about President Obama's comment on the Affordable Care Act - that anyone happy with their current health insurance policy would be able to keep it under the new legislation. Some people have found that this pledge doesn't hold water. Some are labelling it an outright lie.

The Prez has added a caveat, or tweak, more recently to that earlier promise. Speaking to supporters this week in Washington: "Now, if you had one of these plans before the Affordable Care Act came into law and you really liked that plan, what we said was you can keep it if it hasn't changed since the law passed," he said.

Was it a lie originally? Husband and I chatted on the question and couldn't fully agree.

My view is that, if Obama had felt confident enough to make such a statement originally, then there should have been some clause in the Affordable Care Act backing up his pledge and absolutely preventing insurance companies from reneging on, or cancelling, policies if policy holders wished to keep them. Apparently this was not the case. So, either the President was not familiar enough with the complexities of the Act, or it really was a lie to placate opposition. As with everything Obama - we can never be absolutely sure. Either way it was a "misleading statement", deliberate or not, to be added to the roll of "misleading statements" we've heard, since 2007, from Barack Obama.

With regard to the snafus at the Obamacare website - good advice to one and all:


mike said...

Twilight, I've read a number of articles regarding this dilemma. It appears that Obama was correct in his much earlier statements. There are several complexities, which give the appearance of "lies"...but, in my opinion the lies are essentially coming from the Repubs and their associated pundits by not disclosing the details.

Here's a quote from Bob Cesca's piece:

"Sundby wrote that she received a letter from UnitedHealthcare announcing the cancellation of her insurance policy. She was advised to seek a different plan from the ACA exchange in California, known as Cover California. However, she claimed that there aren't any insurance plans in the exchange that are accepted by both her primary care doctors at University of California San Diego, and her oncologists at and Stanford, thus forcing her to choose one or the other.

But here's the thing: Sundby wasn't shoved into this predicament because the ACA law forced her insurance provider out of the ballgame. UnitedHealthcare, one of the most notorious insurance providers before the ACA was passed, responsible for canceling policies and penalizing customers, decided to voluntarily bail out of the individual insurance game as a matter of corporate strategy. In doing so, it could avoid taking on less healthy customers early in the exchange sign-up process, forcing other insurers to absorb the risk. Clever. And sinister."

Please read the entirety of his article, as there are many interesting details, which are corroborated in other articles I've read. There are many ACA half-truths floating our there.

Here's another link about insurance companies intentionally cancelling policies to force customers toward pricier plans:

"Some insurance companies are sending cancellation notices or other "misleading" letters to customers in an attempt to push them into pricier alternatives, according to new reports."

Many insurance plans were simply not worth it, which is why the ACA was enacted:


The fact is, some health insurance on the market today is just lousy. That's a big reason why even people who have insurance can go bankrupt when their medical bills start piling up.

Health insurance you bought for yourself before might have been (or seemed) perfectly okay, but there's a good chance it had big holes in it -- the kind people tend to only find out about when they incur expensive doctor and hospital bills. And if you have a pre-existing condition, or you're older, or you're a woman, you have been paying more for that insurance."

Here's an article that I can't copy and paste...the site won't allow it. Titled "Guess Who Really Wants to Take Away Your Insurance: Republicans"

mike (again) said...

It's a bit of a dichotomy that for the past several decades insurance companies have been vilified as corrupt, out of control profiteers that offered little in the way of coverage at a maximum that insurance companies are required to have STANDARDS through the ACA, those that felt abused, suddenly are crying foul that they are having to accept these standards via implementation of new, standardized insurance plans. Now, they want their old, minimum coverage plans that offer them bankruptcy should the policy holder have anything more than a minor concern, treatable with over-the-counter medicine.

Oddly, the Republicans infer the ACA to socialism and are antagonists toward ACA's implementation. Yet, it was Republican Romney that introduced Romneycare to Massachusetts. The ADA is modeled on Romneycare. Duh!

One strand of hope is that Vermont is testing a single-payer system.

Twilight said...

mike ~ Thanks, I've now read Cesca's article.

I'm not trying to denigrate the ACA - it's better than nothing, and will help a lot of people. I hope that as years pass it will be improved upon, once its weaknesses come to light. It's not fully implemented yet. It'll take a few years to show up all its benefits and its flaws.

It was the "lie" accusations I had mainly in mind, and how President Obama left himself open for such an accusation when it could easily have been avoided.

Cesca wrote So when the president said, "If you like your insurance you can keep it," he meant that the law itself wouldn't force you to call up your insurance provider and cancel your policy if you liked it. Nor was he suggesting that an insurance company would be compelled by the law to keep you as a customer for life, irrespective of circumstances. While the law in fact prohibits the cancellation of a plan if you're suddenly sick or injured, or if you make a mistake on your application -- two common occurrences before the ACA -- you can still lose your plan if you fail to pay your premium or if you lie on your paperwork.

Here's the kicker. The law absolutely prohibits arbitrary cancellations -- except for grandfathered plans like Sundby's UnitedHealthcare plan.

Parsing the President's words now, or tweaking them, isn't helpful - damage has been done. Somebody from the WH should have done that - given such an explanation, months ago!

As a commenter at HuffPo wrote: can only be assumed that a company would do whatever it takes to avoid a loss so this HAD to have been anticipated by the 'experts' because I'm NOT an expert and I saw it coming. They're trying to say that whenever an insurance company acts in its own best interest and makes the decision itself to cancel these plans, the ACA bears no responsibility; this is in spite of the fact that the company is reacting to the ACA, which SHOULD HAVE BEEN ANTICIPATED.

It should have been anticipated and if it had been the President might not have been quite as keen to make the pledge he did.


LB said...

Twilight ~ Yes, the information that was presented to the American people was VERY misleading. And sadly, many of us were also seriously misled as to the affordability and extent of coverages provided under Obamacare and remain unaware.

For instance, many Americans still believe Obamacare, once fully enacted, will provide universal healthcare similar to the coverage available in other industrialized nations, which it won't. Not even close.

Though the President's words may have given many the false impression they'll no longer have to worry about healthcare, not all services will be covered and high deductibles and other out-of-pocket costs will leave many Americans -even those of us with health insurance- without affordable healthcare.

Most people also don't know there is NO REQUIRED CAP on out-of-pocket spending. This requirement was waived.

Have you read the recent Truthout article written by Kevin Zeese and Margaret Flowers on Obamacare? It goes into a number of specifics ALL of us should be aware of - particularly when it comes to the less expensive 'silver' and 'bronze' plans.

mike ~ Much as I wish it wasn't so, with regard to some of your points, once the ACA is enacted (and people have health insurance), for *many* of us there will still be BIG gaps in coverage, BIG medical bills to pay and even bankruptcies . . . basically, we'll still be paying huge sums of money for 'lousy' plans we still can't afford to use.

And just as they've always done, the insurance industry will most likely continue to find ways to avoid covering those of us they can't make a profit off of.

For the most part, insurance is still about all about the profit after all, which means the devil is in the details.

As the authors point out, "Candidate Barack Obama overwhelmingly received more in donations from health care-related industries than any of the other candidates."

Here's the link - the article's title, "Obamacare: The Biggest Insurance Scam in History" speaks for itself, though readers will draw their own conclusions:

Good reading.:)

mike (again) said...

A point that tends to be overlooked in the ACA is that the government subsidies given to the qualifying individuals or families go directly to the insurance companies. The ACA is not a socialist distinctly favors mega-corporate insurance companies. It favors the insurance corporations to stack the cost of policies, as they make that much more money. Is it any wonder the insurance companies are cancelling pre-existing, cheaper plans?! Why make a gob of profit, when a company can make twice-gobs profit?!

mike (again) said...

LB, I'm not defending ACA...I'm responding to today's blog post regarding the purported lies involved. I'd say all sides share blame in the lie-game.

I'm not in favor of ACA and, just like you and Twilight, vastly prefer the single-payer system first proposed by Obama, but decried as socialist by the Repubs. The first conceptions of ACA had some very nice points, but after version 208.6 was passed by Congress (with the help of lobbyists, ie corporations), it stunk.

There's plenty of blame to go from here to the moon and back...but the blame should not be solely placed on Obama...share it amongst all the participants that brought us the final version.

LB said...

mike ~ You're absolutely right. There are are definitely more players involved than the President.:)

In keeping with the spirit of Twilight's post (which is about truth), I think we'd agree the most important thing right now is for all of us to have a better understanding of what Obamacare is and isn't, so that hopefully, we can make wiser choices, now and in the future. It's also important to have a clearer picture of who the primary architects were behind its original design, since it speaks to motivation.

IMO, a lot of the articles written by political pundits strongly supporting one side or the other (Democrat or Republican) tend to skew the facts to suit their purposes and because of that, aren't always as helpful or informative as they might otherwise have been.

My husband and I have spent time searching for affordable insurance on the government website, and though I'm not surprised, the reality hasn't lived up to the rhetoric - which isn't to say *some* of us won't now pay a little less in monthly premiums for the same lousy (inadequate) insurance.

Like they say on the government website, "In general, when choosing your health plan, keep this in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care."

Twilight said...

mike ~ Your point that blame shouldn't be placed solely on Obama was, if I remember correctly, exactly what my husband argued.

Maybe I'm being too literal or pedantic - or something - here, but Obama did speak the words, on several occasions. Those words need never have been spoken, knowing as he should have done that they would not prove to be correct in practice.

Obama was enticing support. He used the words for an ulterior motive - HE did it, not his aides or the insurance companies - HE said the words.

I doubt that single payer will happen in the USA without huge, huge, determined and passionate mass protests - many of them.
As I've mentioned before, it took World War 2 to get the NHS for Britain.

The other thing too, which Americans might not fully realise is that even if single payer were to come about here by some miracle, the cost of living generally would soar. I'm not saying this in opposition to single payer, far from it - health care for everyone is more important than being able to afford luxuries, lots of meals out, vacations, nice clothes - a mortgage...etc.etc. I'm doubtful that enough people realise what comes with a national healthcare service. It ain't free!

LB said...

Twilight ~ Regarding your thinking that cost of living will soar if a single-payer program were to be implemented, maybe this Single-Payer FAQ found on PNPH's website (Physicians for a National Health Program) will help to shed some light:

I'm not an expert (at all), but my understanding is that if a single-payer national health insurance program were to be implemented (one that improves upon and expands the current Medicare system already in place) many of the costs associated with healthcare would go way DOWN.

There was also a study done by a professor of economics at the University of Massachusetts (Amherst) whose results were released in 2013. Among its findings:

"Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

There would even be money left over to help pay down the national debt, he said.

Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014."

Even if it's not the main objective, wouldn't it be great if we could all have access to affordable, comprehensive healthcare and it saved money at the same time?

LB said...

P.S. No need to worry, Twilight. I'll leave it at my last comment and won't belabor the point any more than I already have. I know we'd both like to live in a more just world where people's worth isn't measured by how much power, money or influence they happen to have.

Twilight said...

LB ~ I could be wrong - it's a complex subject. I was voicing what I've found from living in the UK for most of my life and here for 9 years.

I wasn't meaning that the cost of health care itself would go up, but the cost of living all round - everything, because of higher taxes, higher contributions by employers, a substantial contribution by employees for ALL employees, in some form of National Insurance payments or some other label.

Over time these costs seep out into everything - prices in retail outlets, food, hotels, restaurants, gas etc etc.

There are other considerations driving up cost of living in the UK besides the NHS I realise that too. NHS has been in place since the late 1940s, so things have been gradual. I suspect, and could be wrong, that there is a connection though.

The National Insurance contribution paid by employees in the UK is in addition to and separate from Income Tax. It covers health care and retirement pension, and sick pay. Wages and salaries need to reflect the fact that these payments MUST be made. Here in the USA wages of many workers would definitely have to be raised - price hikes would follow - and likely disproportionately too.

As I said, I could be wrong in my assumption, but it perhaps could be borne in mind as a possible, if not inevitable, side effect.

Twilight said...

LB - correction 4th line should say ..."a substantial contribution by employers for ALL employees....."

mike (again) said...

Twilight, I don't believe that Obama intentionally lied about "keeping your pre-existing coverage". Obama is a smart politician. I can't imagine that he would repeat those words as many times as he did, knowing it wasn't truthful, knowing that he was being video-recorded, knowing this would be thrown back at him later. Politicians are sneakier than that!

In the Cesca article I linked earlier, it states:

"The Affordable Care Act, as signed by the president in 2010, states quite clearly that if your individual health insurance plan was in effect prior to March 23, 2010, your plan would be grandfathered as-is, despite new rules that expand mandatory benefits and ban practices such as lifetime limits. In other words, if you signed up for an insurance policy before March of 2010, and if you like that policy, you could ostensibly keep it. It's in the law.

However, an implementation rule was added later by Health & Human Services which narrowed the grandfathering parameters. If the benefits of a policy were altered after that date, those policies would lose grandfathered status. Meanwhile, HHS determined that up to 67 percent of customers would lose their plans, but only as a reflection of normal trends in the system -- not as the result of a sudden drop off due to the ACA."

The line about "if the benefits of a policy were altered after that date"...doesn't that infer that insurance companies altered the policies, therefore making them null? This makes the insurance companies culpable, not Obama.

I suspect insurance companies are gaming this whole mess greatly to their advantage. And I think that the purported Obama lies fiasco is being blown out of proportion by the stick-in-the-hornet-nesters.

LB, I agree with your remarks regarding studies indicating a greater cost saving under ACA.

The USA currently spends a walloping 23% of GDP on health care! This tremendous expense is the leading reason for trying to reduce costs through ACA.

I don't have any insurance coverage currently, but I pay into my county's indigent health care system via my personal property taxes. Ironically, I don't qualify for indigent care! Indigent care provided in the emergency rooms of hospitals is one of the largest incurred costs of health care. If Texas should expand Medicaid (ha, ha, ha), theoretically, my local taxes should decrease and the actual cost of the provided service should decrease.

All of this ACA stuff is a giant GAMBIT right now. I do know that if any company can profit through the ACA loopholes, it will! I do know that if any politician can make another politician look badly through the ACA fiasco, they will! People are more upset over this purported Obama lie than I ever recall from Bush's lies regarding the Iraq-Afghanistan of the purported lies has a FAR LESS CONSEQUENCE. Everyone in the USA could have "free" health care for life for the trillions we've spent of the two wars.

Twilight said...

mike ~ I certainly agree with your last sentence! 200% :-/

Maybe I'm being unfair to Obama, but I still think that when the "implementation rule" was added later Obama or one of his minions, could have made some loud and clear comment then, immediately, leaving no room for doubt and no way for the Republicans to use his earlier pledge as they are doing. Dems should have known this would happen!

Anyway, that being as it may, and the question of single payer being a bit (or a lot) academic at this point, let's just leave it that the whole caboodle could have been designed and handled and explained a whole lot better by all involved, from the get-go.
The people of the USA, whatever their political views, should expect better.