Stu Pedaso

Erie, PA

#1 Nov 6, 2013
Loyal Obama Supporters, Canceled by Obamacare
by Charles Ornstein
ProPublica, Nov.6 2013
.
Lee Hammack and his wife JoEllen Brothers (Photo courtesy of Lee Hammack)

San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.

Since 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietitian and diabetes educator.“We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.

The couple — Lee, 60, and JoEllen, 59 — have been paying $550 a month for their health coverage — a plan that offers solid coverage, not one of the skimpy plans Obama has criticized. But recently, Kaiser informed them the plan would be canceled at the end of the year because it did not meet the requirements of the Affordable Care Act. The couple would need to find another one. The cost would be around double what they pay now, but the benefits would be worse.

“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.

I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA. In many cases, it turns out, the consumers could have found cheaper coverage through the new health insurance marketplaces, or their plans weren’t very good to begin with. Some didn’t know they could qualify for subsidies that would lower their insurance premiums.

So I tried to find flaws in what Hammack told me. I couldn’t find any.

The couple’s existing Kaiser plan was a good one.
Their new options were indeed more expensive, and the benefits didn’t seem any better.
They do not qualify for premium subsidies because they make more than four times the federal poverty level, though Hammack says not by much.
Hammack recalled his reaction when he and his wife received a letters from Kaiser in September informing him their coverage was being canceled.“I work downstairs and my wife had a clear look of shock on her face,” he said.“Our first reaction was clearly there’s got to be some mistake. This was before the exchanges opened up. We quickly calmed down. We were confident that this would all be straightened out. But it wasn’t.”

I asked Hammack to send me details of his current plan. It carried a $4,000 deductible per person, a $40 copay for doctor visits, a $150 emergency room visit fee and 30 percent coinsurance for hospital stays after the deductible. The out-of-pocket maximum was $5,600.

This plan was ending, Kaiser’s letters told them, because it did not meet the requirements of the Affordable Care Act.“Everything is taken care of,” the letters said.“There’s nothing you need to do.”

The letters said the couple would be enrolled in new Kaiser plans that would cost nearly $1,300 a month for the two of them (more than $15,000 a year).

And for that higher amount, what would they get? A higher deductible ($4,500), a higher out-of-pocket maximum ($6,350), higher hospital costs (40 percent of the cost) and possibly higher costs for doctor visits and drugs.

When they shopped around and looked for a different plan on California's new health insurance marketplace, Covered California, the cheapest one was $975, with hefty deductibles and copays.
Stu Pedaso

Erie, PA

#2 Nov 6, 2013
In a speech in Boston last week, President Obama said those receiving cancellation letters didn’t have good insurance.“There are a number of Americans — fewer than 5 percent of Americans — who've got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident,” he said.

“Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy. So a lot of people thought they were buying coverage, and it turned out not to be so good.”

What is going on here? Kaiser isn’t a “bad apple” insurer and this plan wasn’t “cut rate.” It seems like this is a lose-lose for the Hammacks (and a friend featured in a report last month by the public radio station KQED.)

I called Kaiser Permanente and spoke to spokesman Chris Stenrud, who used to work for the U.S. Department of Health and Human Services. He told me that this was indeed a good plan. Patients in the plan, known as 40/4000, were remarkably healthy, had low medical costs and had not seen their premiums increase in years.“Our actuaries still aren’t entirely sure why that was,” he said.

While many other insurance companies offered skimpier benefits, Stenrud said,“our plans historically have been comprehensive.”

Kaiser has canceled about 160,000 policies in California, and about one third of people were in plans like Hammack’s, Stenrud said. About 30,000 to 35,000 were in his specific plan.

“In a few cases, we are able to find coverage for them that is less expensive, but in most cases, we’re not because, in sort of pure economic terms, they are people who benefited from the current system ... Now that the market rules are changing, there will be different people who benefit and different people who don’t.”

“There’s an aspect of market disruption here that I think was not clear to people,” Stenrud acknowledged.“In many respects it has been theory rather than practice for the first three years of the law; folks are seeing the breadth of change that we’re talking about here.”

That’s little comfort to Hammack. He’s written to California’s senators and his representative, House Minority Leader Nancy Pelosi, D-Calif., asking for help.

“We believe that the Act is good for health care, the economy, & the future of our nation. However, ACA options for middle income individuals ages 59 & 60 are unaffordable. We’re learning that many others are similarly affected. In that spirit we ask that you fix this, for all of our sakes,” he and Brothers wrote.

Consumer advocate Anthony Wright said it’s important to remember the way the insurance market worked before the act was passed, when insurers could deny coverage based on pre-existing conditions.“It’s impossible to know what the world would have looked like for these folks in the absence of the law,” said Wright, executive director of the group Health Access.

“We certainly had an individual market, especially in California which was the Wild Wild West, where there was huge price increases, cancellations, a range of other practices.

“That doesn't mean that there were certain people who lucked out in the old system, who wound up in a group with a relatively healthy risk mix and thus lower premiums,” he added.“The question is: Is health insurance something where people get a rate based on the luck of the draw or do we have something where we have some standards where people who live in the same community, of the same age, with the same benefit package are treated equally?”

Wright said discussions should focus on how to provide consumers like Hammack with assistance if they barely miss qualifying for subsidies.
Stu Pedaso

Erie, PA

#3 Nov 6, 2013
So what is Hammack going to do? If his income were to fall below four times the federal poverty level, or about $62,000 for a family of two, he would qualify for subsidies that could lower his premium cost to as low as zero. If he makes even one dollar more, he gets nothing.

That’s what he’s leaning toward — lowering his salary or shifting more money toward a retirement account and applying for a subsidy.

“We’re not changing our views because of this situation, but it hurt to hear Obama saying, just the other day, that if our plan has been dropped it’s because it wasn’t any good, and our costs would go up only slightly,” he said.“We’re gratified that the press is on the case, but frustrated that the stewards of the ACA don’t seem to have heard.”
Tim Leary

Erie, PA

#4 Nov 6, 2013
“That’s what he’s leaning toward — lowering his salary or shifting more money toward a retirement account and applying for a subsidy.”

So, in order to avoid paying more for their insurance like the rest of us (as a direct consequence of their misguided liberal policies) these two vile liberal scumbags are going to shuttle money around so that others in society are legally obligated to subsidize their expenses. This is why liberals are deplorable people—they destroy everything they touch and then steal from others to avoid atoning for their philosophical sins.
union yes

Erie, PA

#5 Nov 6, 2013
He did all of his complaints and then wrote asking his Senators for his particular situation to be remedied. He said he still wanted Obamacare to work.
See, that is the liberal mind…Fix it for me, as I am “special” because I am 59 and 60, and don’t want to work hard enough to pay for what I am supporting.
Really, See he is a fake. He wants everyone else to suffer, but not him, so he is asking for a special consideration.
Liberals like this make me sick.
too funny

Erie, PA

#6 Nov 6, 2013
“San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are ‘cradle Democrats.’” Now they can be “grave democrats.” The two stooges will find no health care in Hell!
TWTL

Erie, PA

#8 Nov 6, 2013
Let me see if I get this right: After 3 years of ignoring warnings about *this very thing*, you’re upset that it happened? And, now that it happened, you’re appealing to one of the law’s biggest supporters to save you from it?

These people believe it’s still a good law, just…not…for…them…so they ask Pelosi to change it *for them*

Liberalism knows no limits to its hypocrisy. Incredible, really.
Rick

Erie, PA

#9 Nov 6, 2013
Obama voters” are getting exactly what they voted for. Twice. They deserve no quarter and will get none. Warnings of impending doom from all directions and sources went unheeded by these smug elites. Opposing points of view were shouted down as “racist” or outright ignored.
These clowns have laid down with dogs and now they have fleas. Tough. Take your medicine fools. You’re going to hurt just like everyone else because of your foolish stupidity.
The failed policies of the past are just that. FAILED. I suggest you look up the definition of insanity and take what you learn to heart.
Obama has been a disaster for America and the responsibility for it is on his supporters heads. When the country finally can print no more money, cash or electronic, and the EBT cards stop working guess where the holders of those EBT cards are going to do their grocery shopping!
Thanks for nothing liberals and RINOS! You have just about played your games and run the country right out of existence. Can you say CHINESE YUAN?
It has been my experience that trying to talk to a liberal results in a net gain of zero. I suspect this little rant will result in the same. Zero. I, for one, am sick of liberals and their stinkass smelly armpits and greasy unwashed hair and bad breath to go along with their forever open mouths spewing idiocy in all directions. You wore out your welcome a long time ago (circa J. Carter). Now, stop your crying and reap your reward for your ignorance. Obamacare, puh…
anon

Erie, PA

#10 Nov 6, 2013
So this couple has discovered that Obama blatantly lied to them, sees that the financial and medical consequences for him and his wife are potentially devastating, yet he says:

“We believe that the Act is good for health care, the economy, & the future of our nation. However, ACA options for middle income individuals ages 59 & 60 are unaffordable. We’re learning that many others are similarly affected. In that spirit we ask that you fix this, for all of our sakes.”

He believes that? despite his seeing, right in front of his face, that it is none of those things?

So if somehow Pelosi can fix this law for HIM, then he is sure everything will be fine for everybody. It doesn’t seem to occur to him that perhaps those of us who said for the past 3+ years this law was a disaster just might have known what we were talking about?

And his president lying to him about it for these years isn’t an issue either.

He reminds me of the Danville, CA man who recently had a similar experience and said:

“I have been all for the ACA. I just didn’t know that I personally was going to have to pay for it.” So as long as someone else had to pay for it, and someone else had to suffer the consequences, then it was fine, Now that it is HIM the law needs to be changed.

Hypocrisy is too mild a word.
Trashbagger liberal

Erie, PA

#11 Nov 6, 2013
There are several interesting aspects to this article. The first is the “surprise” that the policy owned before was not a cut rate policy. Why should it be? The insurance industry is one of the most regulated industries in the country and the cut rate policies that took advantage largely disappeared a long time ago. It is as though there is this blind belief in what Mr. Obama says about previous insurance is absolutely true and does not need to be questioned. Right! I assume people do not realize that the Bronze Plan under Obamacare offers less than that legally allowed in some states like NY before Obamacare became the la.

Second, why are people shocked to discover that when you cover more benefits and cover people with pre-existing conditions that rates go up. This naïve belief in something for nothing is shocking when heard from people who are supposedly educated.

Third is their response to this crisis. Instead of manning up and simply stating that they voted for it, that they supported Obamacare and that they would pay the increased price, they take the reprehensible approach of trying to earn less money so that they can get subsidies. Yep, they voted for everyone to suffer from this and when they are confronted with its reality, this couple runs to the idea of manipulating their income such that they can let the tax payers provide them a subsidy. I guess it is easy to vote for expensive stuff when it is other people’s money you are going to use.
Barney McGurk

Erie, PA

#12 Nov 6, 2013
I find this so entertaining. Here is a Kool-Aid drinking Obamaclown who votes for the guy, agreed no doubt with Pelosi that he will find out what is in the ACA after it passes….no need to read it. Would he read a contract for an installment purchase of an automobile? Of course he would. Lesson:
Trust your politicos and you become the vehicle for they becoming wealthy…at your expense. Pelosi and Obama couldn’t care less about you Mr Hammock. Now that your poor judgement has come home to roost, you are trying to find a way for taxpayers to pay for your healthcare. I as a taxpayer am not responsible for your ignorance and poor judgement…and I resent your expecting me to bail you out when you represent those who would further harm this country. ENOUGH!!! Obviously educated beyond his ability to use it.
Barry Dain Steinhagen

Erie, PA

#13 Nov 6, 2013
Liberalism/socialism/communism always eat their own; no matter if you are a loyal true believer or a low information casual voter. The Liberalism/socialism/communism solution is always dehumanizing and potentially lethal. The opponents of the ACA and Obama have been screaming this at the top of their lungs since before the 2008 elections. What did they get for their troubles? They are called crazy, radical, and “tea-baggers”. I hope all of you left wingers choke on the ACA,
Pedro

Erie, PA

#14 Nov 6, 2013
Can we stop pretending this was ever about healthcare and not just a massive money grab by Obama and his cronies, which include many republicans.

They were able to get the PPACA through the Supreme Court by arguing it was just a new tax. He was able to get re-elected by deliberately lying about the provisions in this law (among a host of other things).

~$680M on a website that doesn’t work, paid to a company owned by friends of the Obamas. Sucking money out of “middle-class” families’ pockets, an example being the one in this story. etc etc

A bloated, corrupt, deceitful, ineffective, overreaching government is what we have allowed ourselves to evolve into. The question I ask every day is can this be corrected or have the power brokers reached the critical mass that will allow them to keep the pendulum from swinging back to the other direction?

Washington is Rome and we are the unwashed masses, the mob. The only person looking out for your best interest is you, not anyone in Washington.

“Hope and change” really just meant that you can hope to have more than just change in your pocket, but chances are your wealth will be redistributed in accordance with the fundamental transformation of our society.
Patty Cuneo

Erie, PA

#15 Nov 6, 2013
Well. A couple things they can do to help with the sticker shock is,

#1: Start working nights, and weekends. Maybe getting a part time job will help pay all the new expenses, deductibles, etc. Plus, they can pay more taxes. Liberals are all for more taxes. Then that money, can be used to subsidize an illegal immigrant, gang member in LA.

#2 Work less hours, and not make as much moolah. Then they will qualify for subsidies. They can sign up for food stamps, and public housing, to help offset the lost wages. Thats would I would do if I was them. Liberals love all these programs anyway!!

#3 They could jump off the Golden Gate Bridge, and plunge to their deaths. Then they wont have to worry about health insurance at all.

These are just a few of the many, many, options out there to ease the pain.
Tacks Know More

Erie, PA

#16 Nov 6, 2013
LOL, typical liberals. They say the Democrats’ latest socialist scheme is magnificent, perfect, great for everyone in the country, but they need an exemption to it.
Autumn

Erie, PA

#17 Nov 6, 2013
Boo hoo. You voted for it, you got it. But how elitist!“Ours is the worst sob story.”“For middle incomers our age it’s ‘unaffordable’.” You are not the only ones in this position - not by a gosh darn long shot. It is hideous and horrendous for MANY citizens of all conditions and ages. It’s a leaky boat. But you helped put the hole in it. Obama is a disaster and so is Obamacare.
Toxie The Toxic Avenger

Fort Washington, MD

#18 Nov 7, 2013
And you just made one of the proponets of obammy care county executive!
black deadbeat moron

Lodi, OH

#19 Nov 7, 2013
i love my obamacare package !
ETN Editorial Board

Erie, PA

#20 Nov 7, 2013
The point remains that it is unlikely that there are more than a handful of plans in the entire country that covered the four corners of requirements HHS wrote into the rules. In short, the ACA cancelled nearly everyone’s individual plans. Whether insurance companies lobbied for a uniform cancellation date is immaterial.

This was known and voted on by the senate when Charles Grassley brought a resolution to the senate floor in September 2010. It was clear then that HHS’ June 2010 rules would cancel plans across the country and Grassley’s resolution would have stopped that. Senate democrats voted unanimously to defeat it - they’ve been lying ever since.

The cost to administer this monstrosity will likely be 25-30% when you factor in HHS, CMS, IRS, Justice and on and on. Unlike insurance companies, the feds spread administrative costs around so you won’t know how outrageous they are.

It makes no sense to disrupt 85% of the country to fix the fact that 15% of the population was uninsured. It’s a bad bill and a bad plan.

It will not work because it is:
1) Technologically inept
2) Consumer fraud on a grand scale
3) Economically inviable

Why not report the truth - your plan is being cancelled so we can overcharge you in order to subsidize everybody else. Is that so hard to say?

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