Michael Mayo, Contact Reporter
Sun Sentinel Columnist
November 29, 2015
Obama Big lies – ‘Affordable care’ and ‘you can keep your doctor’
No matter how you get health insurance — through your employer, on your own or with the help of a federal subsidy through the HealthCare.gov marketplace — you’ll likely pay more next year and get less coverage.
Consumers face higher premiums, higher deductibles and copays, higher out-of-pocket maximums. And things that used to be fully covered, such as blood work tests and scans, might trigger charges you’ve never been asked to pay before.
“Everyone’s getting squeezed,” said Shawn DeRosa, 41, of Dania Beach, a self-employed worker facing a 20 percent premium hike on his non-Obamacare policy. “We’re paying close to $12,000 a year between premiums and deductibles, and when you go to a doctor’s office or diagnostic center, you’re always asked for more.”
“I don’t feel like we got what [President Obama] said we were going to get,” said Pattie Chase, 64, a retiree from Fort Lauderdale. She has bounced around several different subsidized Obamacare plans since her previous insurer stopped offering a cheap plan that didn’t conform to new standards in 2014.
So here we are, heading into Year 3 of Obamacare enrollment and the final year of Obama’s presidency, and there seems to be as much distrust and disgust over health insurance as ever. Our system is still expensive, inefficient and inscrutable. The Affordable Care Act hasn’t necessarily made things more affordable.
Yet it has made insurance more accessible, certainly a positive. Around 1.2 million previously-uninsured Floridians have gotten health insurance in the last two years, including those with pre-existing conditions denied in the past.
For all the Democratic politicians touting the wonders and benefits of the law, some regular folks aren’t finding things so wonderful. Many are still smarting from this decade’s biggest political lie, Obama’s declaration that, “If you like your doctor, you can keep your doctor.”
“It certainly wasn’t true with any of my doctors,” Chase said.
Chase and DeRosa both told me of unwanted disruptions because of insurance switches and mid-year changes in plans’ doctor networks. When Chase switched to a subsidized Obamacare plan, she had to give up the primary care doctor she had for 20 years. DeRosa said his wife had two OB/GYNs abruptly drop from their plan, which he called stressful because she had a pre-cancerous condition being monitored.
DeRosa has had the same insurer for the last eight years, but a cheaper plan was discontinued because of new Obamacare rules. Even though he’s not on a federally-subsidized plan, he gets the sense that costs associated with expanded insurance are being spread across all plans, to consumers in all income brackets.
Last year, he said his wife’s specialized mammogram was fully covered. This year his insurer wants to charge $400 for the same test done at the same place. “I’m fighting it,” said DeRosa, a life insurance broker. He said women’s preventative screenings are supposed to have no out-of-pocket cost.
Some insurers are complaining about losses and higher-than-expected costs, with health giant United Healthcare recently saying it might pull out of the federal exchange in 2017. Yet most health insurance stocks are trading at prices two-to-three times higher than five years ago. Florida hospitals recorded record profits last year.
Chase said she paid $220 a month for insurance the year before Obamacare, but the plan was discontinued. In 2014, she paid $442 a month after her subsidy (the total cost was $712 monthly). She was surprised when she was hit with an $800 charge for a dermatologist visit to remove a cancerous skin cell.
“Go figure, on a $220-a-month plan pre-Obamacare everything is paid for, but on a $712-a-month plan you can have a big out-of-pocket expense,” she said. “Something is definitely wrong with this picture.”
DeRosa is angered by the system’s opaqueness. After he had two MRIs for a back problem, paying $300 each time, he said he pressed his insurer for negotiated rates and potential out-of-pocket costs at local imaging centers. “They wouldn’t provide it to me,” he said. “Insurance companies are the gatekeepers to all this information, and they’ve created all these uncertainties for their own customers.”
DeRosa is equally frustrated by government. He wrote a long letter to U.S. Rep. Debbie Wasserman-Schultz (D-Weston), his congresswoman. When he followed up with a phone call to her office, he said he was told that because he wasn’t on a subsidized Obamacare plan, it was a state issue.
“She was a chief supporter of this law, and my original insurance plan was shut down because of the ACA and now she’s passing the buck,” DeRosa said. “As a constituent, I feel like she doesn’t care.”
For Democrats heading into an election year and Obama’s legacy, this could be a problem. The Affordable Care Act might go down as the Unaffordable We-Don’t-Care Act.
Subscribe Israel Commentary: www.israel-commentary.org
Powered by Facebook Comments