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[Yet] Another Obamacare Horror Story DEBUNKED

Posted: Nov 1, 2013

Another Obamacare horror story debunked

CNBC's Maria Bartiromo fails to walk the last mile with Deborah Cavallaro, lower right.(CNBC)

By Michael Hiltzik

October 30, 2013, 3:26 p.m.

Deborah Cavallaro is a hard-working real estate agent in the Westchester suburb of Los Angeles who has been featured prominently on a round of news shows lately, talking about how badly Obamacare is going to cost her when her existing plan gets canceled and she has to find a replacement.

She says she's angry at President Obama for having promised that people who like their health plans could keep them, when hers is getting canceled for not meeting Obamacare's standards.

"Please explain to me," she told Maria Bartiromo on CNBCWednesday, "how my plan is a 'substandard' plan when ... I'd be paying more for the exchange plans than I am currently paying by a wide margin."

Bartiromo didn't take her up on her request. So I will.

The bottom line is that Cavallaro's assertion that "there's nothing affordable about the Affordable Care Act," as she put it Tuesday on NBC Channel 4, is the product of her own misunderstandings, abetted by a passel of uninformed and incurious news reporters.

I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.

Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder.

* It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year.

* Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.

This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy. [AKA "junk insurance"]

As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.

Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy.

At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.

Is that better than her current plan? Yes, by a mile.

If she wanted to pay less, Cavallaro could opt for lesser coverage in a "bronze" plan. She could buy one from the California exchange for as little as $194 a month. From Anthem, it's $256, or $444 a year less than she's paying now. That buys her a $5,000 deductible (the same as she's paying today) but the out-of-pocket limit is lower, $6,350. Office visits would be $60 for primary care and $70 for specialties, but again with no limit on the number of visits. Factor in the premium savings, and it's hard to deny that she's still ahead.

Cavallaro told me a couple of things that are worth considering. First, what she likes about her current plan is that she can go to any doctor of her choice and any hospital. That's not entirely true, because her current plan with Anthem does favor a network. Plainly, however, it's broad enough to serve her purposes. She's concerned that the new plans will offer smaller networks, which is probably true, though it's not necessarily true that the new networks will exclude her favorite doctors, hospitals or prescription formularies.

[From ne, note that that's only technically true because with the junk policy she purchased and her current income, in actuality she can't afford to go to ANY doctor outside of the TWO annual doctor visits her carrier will graciously charge her ONLY $40 each for in return for the $3516 premium she was looking forward to paying next year. It's not clear if she has to meet her $5000 deductible first, before these two.]

She also mentioned that her annual income fluctuates. It can be substantially lower, or substantially higher, than it is this year. What if next year she earns too much to qualify for the subsidy? Also a fair point -- at her current income, the subsidy is worth more than $200 a month to her. But that's not the same as saying that "there's nothing affordable about the Affordable Care Act," because at her current income, the act is vastly more affordable to her than what she's paying now.

When she told Channel 4 that "for the first time in my whole life, I will be without insurance," it's hard to understand what she was talking about. (Channel 4 didn't ask.) Better plans than she has now are available for her to purchase today, some of them for less money.

The sad truth is that Cavallaro has been very poorly served by the health insurance industry and the news media. It seems that Anthem didn't adequately explain her options for 2014 when it disclosed that her current plan is being canceled. If her insurance brokers told her what she says they did, they failed her. And the reporters who interviewed her without getting all the facts produced inexcusably shoddy work -- from Maria Bartiromo on down. They not only did her a disservice, but failed the rest of us too.

[But let's not forget to note that above all she failed herself, even if her noisy silliness did get her on several TV shows. Only those who don't believe she has any duty to society will think that's the worst of her behavior.]

Fellow Traveler

;

Prices so far seem to be a bit of a crap shoot. Most - do better, some far better, but deductibles and

[ In Reply To ..]
premiums being quoted by insurance companies on the exchanges are varying widely - depending on federal versus state exchanges, region of the country, urban versus rural (fewer companies competing in the country), age of shoppers, etc.

Obamacare set new standards for what policies must cover, eliminating junk insurance from the exchanges, requiring companies to cover preexisting conditions, eliminating lifetime limits for an illness, requiring some preventive care, such as annual checkups and colonoscopies, be covered 100% and without deductible, and other benefits that make us all winners.

But in the end, people are buying an extremely expensive and valuable product offered by for-profit insurance companies. That lower and lower-middle income people can afford healthcare coverage at all is due to the subsidies.

Stage 2, after we get most of the bugs out of this, getting the deductibles down. We need a far less expensive single payer option available for those who want it.

They aren't reporters they are teleprompter - READERS

[ In Reply To ..]
Seriously, is anyone REALLY fooled into thinking these are real journalists or even reporters? They didn't press this woman because that is part of the plan - PRETEND you are offering real news under the guise of furthering an agenda.

It makes me sick.

For me the key issue is.... Sm - Old Woman

[ In Reply To ..]
Obama LIED when he said that if we liked our current insurance, we could keep it. I don't know this woman about whom the article is written, but assuming she is a middle-aged, healthy woman without any serious medical issues, perhaps a catastrophic plan is best for her. I understand the need for preventive health screenings to ensure adequate monitoring of a person's health, but to DEMAND that a person have an annual physical exam and/or colonoscopy is just plain wrong. Allowing the government to further dictate our health care is just wrong, especially when that same government does not deem it "necessary" for themselves or their dependents.

In my opinion, this goes much, much deeper than just being forced to obtain insurance and to lose a policy that suits your needs just because the government deems it does not. Slowly but surely, the Obama Administration is overtaking all aspects of our private lives and we continue to allow this to happen. Welcome to the Communist Socialist Republic of America.

Careful! If you don't schedule your colonoscopy by - 03/1/14 the brown shirts come for you. At night. n

[ In Reply To ..]
x

That's really about the only way you can respond - to the post above yours

[ In Reply To ..]
because clearly some people WANT to believe the worst things possible about either Obama, ACA, or both.

When the obvious has been stated... Sm - Old Woman

[ In Reply To ..]
more than once and from more than one source with first-hand KNOWLEDGE of what this ACA/Obamacare is doing, then I think it bears at least listening to. I would LOVE to believe that the new insurance legislation would make a hugely positive impact on our healthcare, even though I don't believe that government should be in charge of our healthcare and our personal health records, but sadly I just cannot when I hear stories like the one at the top of this thread and countless others who have lost their insurance, either because the almighty government believes it to be inadequate (based on the larger population's healthcare needs and not on the individual) or because insurance companies are pulling out of certain states because their policies do not measure up to the exchange requirements or cannot compete based on premium amounts.

Yes, I would LOVE to believe in a world where we can all have equality of healthcare regardless of our financial standing, but under the current plan, it is NOT equality because it is the working class and upper class who are paying for those who refuse (not those who are not able) to get out and get a job and pay for their own. We already have Medicaid for those who don't want to work for a living. Why should we give them more?

obvious by whose account? Yours? - You don't state

[ In Reply To ..]
Clearly you posted your opinion and that's fine, but that's really all you posted. There are other sources with a different take on the plan - but you don't quote any of those for balance.

See the problem?

Well...sm - Old Woman

[ In Reply To ..]
If you look at this from CBS news, you will see that people are losing their healthcare because they are not allowed to renew their current policies by the thousands: CBS News has confirmed with insurance companies across the country that more than two million people are getting notices they no longer can keep their existing plans. In California, there are 279,000; in Michigan, 140,000; Florida, 300,000; and in New Jersey, 800,000. And those numbers are certain to go even higher. Some companies who tell CBS News they've sent letters won't say how many. (source http://www.cbsnews.com/8301-505263_162-57609737/obamacare-more-than-2-million-people-getting-booted-from-existing-health-insurance-plans/)

CBS IS a credible source, is it not? If not, I found this article from Forbes that explains things in a little more detail. http://www.forbes.com/sites/theapothecary/2013/10/31/obama-officials-in-2010-93-million-americans-will-be-unable-to-keep-their-health-plans-under-obamacare/
Just copy and paste that into your browser if you want to read all of it, but here are some excerpts I found interesting:

"On Tuesday, White House spokesman Jay Carney attempted to minimize the disruption issue, arguing that it only affected people who buy insurance on their own. “That’s the universe we’re talking about, 5 percent of the population,” said Carney. “In some of the coverage of this issue in the last several days, you would think that you were talking about 75 percent or 80 percent or 60 percent of the American population.” (5 percent of the population happens to be 15 million people, no small number, but let’s leave that aside.)

By “coverage of this issue,” Carney was referring to two articles. The first, by Chad Terhune of the Los Angeles Times, described a number of Californians who are seeing their existing plans terminated and replaced with much more expensive ones. “I was all for Obamacare until I found out I was paying for it,” said one.

The second article, by Lisa Myers and Hanna Rappleye of NBC News, unearthed the aforementioned commentary in the Federal Register, and cited “four sources deeply involved in the Affordable Care Act” as saying that “50 to 75 percent” of people who buy coverage on their own are likely to receive cancellation notices due to Obamacare."

"“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34,552 of the Register. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and become illegal. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013.

Another 25 million people, according to the CBO, have “nongroup and other” forms of insurance; that is to say, they participate in the market for individually-purchased insurance. In this market, the administration projected that “40 to 67 percent” of individually-purchased plans would lose their Obamacare-sanctioned “grandfather status” and become illegal, solely due to the fact that there is a high turnover of participants and insurance arrangements in this market. (Plans purchased after March 23, 2010 do not benefit from the “grandfather” clause.) The real turnover rate would be higher, because plans can lose their grandfather status for a number of other reasons.

How many people are exposed to these problems? 60 percent of Americans have private-sector health insurance—precisely the number that Jay Carney dismissed. As to the number of people facing cancellations, 51 percent of the employer-based market plus 53.5 percent of the non-group market (the middle of the administration’s range) amounts to 93 million Americans."

Now, here's the kicker....."President Obama’s famous promise that “you could keep your plan” was not some naïve error or accident. He, and his allies, knew that previous Democratic attempts at health reform had failed because Americans were happy with the coverage they had, and opposed efforts to change the existing system.

Now, supporters of the law are offering a different argument. “We didn’t really mean it when we said you could keep your plan,” they say, “but it doesn’t matter, because the coverage you’re going to get under Obamacare will be better than the coverage you had before.”

But that’s not true. Obamacare forces insurers to offer services that most Americans don’t need, don’t want, and won’t use, for a higher price. Bob Laszewski, in a revealing blog post, wrote about the cancellation of his own health coverage. “Right now,” he wrote, “I have ‘Cadillac’ health insurance. I can access every provider in the national Blue Cross network—about every doc and hospital in America—without a referral and without higher deductibles and co-pays.”

But his plan is being canceled. His new, Obamacare-compatible plan has a $500 higher deductible, and a narrower physician and hospital network that restricts out-of-town providers. And yet it costs 66 percent more than his current plan."

AND... "It was well known, as far back as 2009, that millions of Americans would lose their existing coverage under the Obamacare bill."

Both CBS News and Forbes magazine are reputable sources of information, each highly respected in their individual media markets. I hardly think you can argue with this.

Old, NO ONE ever stated people were required to - get PEs and colonoscopies. INSURANCE

[ In Reply To ..]
COMPANIES are now REQUIRED to provide them as already paid for by the thousands of dollars you send them each year. As PREVENTIVE CARE so that, hopefully, your policy never pays out big.

Now, if you got that basic concept so wrong, maybe it would help to start over? We all need this knowledge to Take -- Care -- Of --Ourselves. It's really not about throwing words back and forth here.

ObamaCare Simplified Explanation in Bullet Points

Here is a simplified ObamaCare explanation of what every American should know about our new health care law. The Affordable Care Act (ACA) does a lot, luckily most of us donâ��t need to know the details, let's take a look at what we do need to know:

â�¢ ObamaCare doesâ��t create health insurance, it regulates the health insurance industry and helps to increase quality, affordability and availability of private insurance.

â�¢ Most people who currently have health insurance can keep it.

â�¢ Young adults can stay on their parents plan until 26.

â�¢ If you donâ��t have coverage, you can use the new Health Insurance Marketplace to buy a private insurance plan.

â�¢ Open enrollment in the Health Insurance Marketplace goes from October 1st, 2013 to March 31st, 2014.

â�¢ If you donâ��t obtain coverage or an exemption by January 1st, 2014 you must pay a per-month fee on your federal income tax return for every month you are without health insurance.

â�¢ In 2014 the fee is $95 per adult ($47.50 per child) or 1% of income, whichever is higher. The family max is $285.

â�¢ The cost of your marketplace health insurance works on a sliding scale. Those who make less, pay less.

â�¢ American making less than $45,960 as individual or $94,200 as a family of 4 may be eligible for premium tax credits through the marketplace. Tax credits subsidize insurance premium costs.

â�¢ If you are able to get qualified health insurance through your employer you wonâ��t be able to receive marketplace tax credits unless the employer doesnâ��t cover at least 60% of your premium cost, doesnâ��t provide quality insurance or provides insurance that exceeds 9.5% of your families income.

â�¢ Up to 82% of nearly 16 million uninsured young U.S. adults will qualify for federal subsidies or Medicaid through the marketplace.

â�¢ You donâ��t have to use the marketplace to buy insurance, but you should fill out an application to see if you qualify for assistance before shopping for insurance outside of the marketplace.

â�¢ The ACA does away with pre-existing conditions and gender discrimination so these factors will no longer affect the cost of your insurance on or off the marketplace.

â�¢ You canâ��t be denied health coverage based on health status.

â�¢ You canâ��t be dropped from coverage when you are sick.

â�¢ Health Insurers canâ��t place lifetime limits on your coverage. As of 2014 annual limits are eliminated as well.

â�¢ All new plans sold on or off the marketplace must include a wide range of new benefits including wellness visits and preventative tests and treatments at no additional out-of-pocket cost.

â�¢ All full-time workers who work for companies with over 50 employees must be offered job based health coverage by 2015. Employers who do not offer coverage will pay a per-employee fee.

â�¢ Small businesses with under 50 full-time employees can use a part of the marketplace called the SHOP (small business health options program) to purchase group health plans for their employees.

â�¢ Small businesses with under 25 full-time employees can use the marketplace to purchase subsidized insurance for their employees.

â�¢ Medicare isnâ��t part of the marketplace. If you have Medicare keep it!

â�¢ Medicaid and CHIP are expanded to provide insurance to up to 16 million of our nations poorest.

â�¢ When you apply for the marketplace youâ��ll find out if you qualify for free or low-cost coverage from Medicaid or the Childrenâ��s Health Insurance Program (CHIP). Youâ��ll also be made aware if you qualify for Medicare.

Here's the site: http://obamacarefacts.com/obamacare-explained.php

Hung Up On The Word LIAR? - *Seriously

[ In Reply To ..]
I know: Let's play a game of who's the LIAR? I'll list some lies, and then people can guess who is the LIAR.

Go.

Says the Democrats told the Catholic Church that theyâ��ll use federal powers to shut down church charities and hospitals if the church doesnâ��t change its beliefs. ?

Says Barack Obama "began his presidency going on a worldwide apology tour." ?

Says "a strong bipartisan majority" in the House of Representatives "voted to defund Obamacare." ?

Says UPS left 15,000 employeesâ�� spouses "without health insurance" and told them to, "go on an exchange with no employer subsidy." ?

Clock ticking.........

Time's up!

Ted Cruz

One more for the road:

Said "My parents or my baby with Down syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide whether they are worthy of health care." ?

Too easy.

Sarah Palin

Dontcha just hate politicians that are LIARS?

Politicians lie.... Sm - Old Woman

[ In Reply To ..]
They wouldn't be elected if they told the truth... That they are not capable of the superhero feats that they tell us they are. As far as what Ted Cruz might or might not have said, I'm not sure how it relates to this thread, but he, again, is a politician.

I don't know Obama well enough to dislike him personally, but I can tell you I do not like his politics. I believe he is taking this country in a direction we don't need to be going. I "hope" that "change" is working for you, because it certainly is not for me.

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