From 'I don't want any part of Obamacare' to 'It's a godsend'

[ProSense]

From 'I don't want any part of Obamacare' to 'It's a godsend'

by Joan McCarter

Last year, TIME published a massive special report, "Bitter Pill: Why Medical Bills Are Killing Us," detailing just about everything that is wrong with the nation's health care system. Central to that story were Stephanie and Sean Ricci, an Ohio couple with two kids who had just started up a new business, and who had just been struck by Sean's aggressive and expensive cancer. The author of that story, Steven Brill, has a an update to their story in the current issue of TIME. Sean Ricci's now in remission, but only after the under-insured family (their $469/month policy was worthless at the MD Anderson Cancer Center in Houston) borrowed from family and maxed out their credit cards. Here's Stephanie Ricci last October:

I don't think Obamacare will help us. I don't want anything to do with it," Stephanie Recchi told me a week after the launch of HealthCare.gov on Oct. 1. "I hear a lot of bad things about it—that it doesn't cover pre-existing conditions and it's too expensive," she added, referring to what she said were "television ads and some politicians talking on the news. Just a lot of talk that this is a bad law."

Did I mention she's an Obama hater? Nonetheless, she tried and tried again to navigate HealthCare.gov, to no avail. That made her hate the whole idea of Obamacare even more, but she needed health insurance, and so went to her insurance agent.

"When they came to my office, Stephanie told me right up front, 'I don't want any part of Obamacare,' " recalls health-insurance agent Barry Cohen. "These were clearly people who don't like the President. So I kind of let that slide and just asked them for basic information and told them we would go on the Ohio exchange"—which is actually the Ohio section of the federal Obamacare exchange—"and show them what's available."

The upshot? Because they're still in basically start-up mode in their business, their income for the family of four qualifies them for expanded Medicaid. If a big contract they are anticipating comes through for them this year, they'll be bumped off Medicaid, but will still qualify for a subsidy that will put their monthly premiums at $566.

What Stephanie soon discovered, she told me in mid-November, "was a godsend." <...>

"Here I get full protection for $566, compared to no protection for almost $500," Stephanie says, referring to her old plan that had cost $469 monthly and that MD Anderson had scoffed at. "This is wonderful. <...> No, we don't get MD Anderson, but we do get the Cleveland Clinic and lots of other good care," Stephanie says. "We understand that." Amid the likely attacks from his opponents that he's taking away patients' favorite doctors and hospitals, Obama has to hope that others come to share her attitude.

As Brill points out, if the Riccis had been living in Texas, where Sean got cancer treatment, or in any of the other states that refused Medicaid expansion, they'd still be screwed. They'd be in the Medicaid gap that millions of Americans, many with health issues as critical as Sean Ricci's, have fallen into. That's the kind of situation that the Affordable Care Act was supposed to end for everyone. It was supposed to mean. Thanks to the Supreme Court and an intractable Republican party that has invested more into fighting Obama than into fighting for their constituents, being able to access and afford health care is still a matter of luck.

http://www.dailykos.com/story/2014/01/17/1270505/-From-I-don-t-want-any-part-of-Obamacare-to-It-s-a-godsend

[FSogol]

1. K&R. n/t

[ProSense]

2. Kick! n/t

[mcar]

3. Good health to them

Maybe they'll figure it out and vote Dem next time.

[aggiesal]

15. If they're still watching Faux News . . .

they'll no doubt still vote (R).

I'll even bet that they don't realize that they got Obamacare.
They went on the Ohio exchange.

[Egnever]

4. Typical

Not the least bit surprising.

I love that their agent had to trick them into it

[Iliyah]

5. K & R

[sheshe2]

6. K&R! for Obamacare!

Signed Sealed and Delivering~

[Thinkingabout]

7. I think the availability of affordable health insurance is a wonderful thing, how the

Doubters believe the lies put out by the GOP and FOX news liars but don't believe in the information available on the healthcare.org site in not a smart decision. No matter if I "hated Obamacare" I would love my family more.

I listened to a lady of Medicare age shortly after ACA passed talking about how we had a wonderful healthcare system but Obamacare had just ruined the system, at that time nothing had started in ACA. Guess what, she was a faithful FOX listener.

[SHRED]

23. Just because it's "available" doesn't make it a wonderful thing

My wife and I are finding out that within the subsidized Covered California exchange, insurance companies have extremely small networks and doctor participation (choice) is dismal. I am thankful we can get coverage outside of employer-based coverage however these failings are coming as quite a shock and inconvenience for us. Very disappointed at the limitations of care options. The exchange truly is a “bottom-tier” health insurance system compared to my employer-based coverage which ends in April.

Glad we can get coverage but there is a not so good side too.

[Control-Z]

24. We now have insurance through

Covered California and there are over 800 providers just in the 5 miles of our home.

Even our current physicians, who don't yet show up on the provider search, actually do accept the insurance. I love the policy we now have. After paying for crappy private insurance for almost 20 years our premium is much lower, co-pays are lower, and the coverage is excellent.

I'm sorry to hear you're not feeling the same.

[Thinkingabout]

28. Did you have more than one choice?

[SHRED]

29. Here's what UCSD accepts

UC San Diego Health System and the Health
Insurance Exchange
Certain health insurance plans available through Covered California provide in-network access to UC San Diego Health System doctors and services. Those plans include:

Anthem Blue Cross EPO – Platinum, Gold, Silver and Bronze
Health Net PPO – Bronze

http://health.ucsd.edu/patients/Pages/covered-ca.aspx

---

Health Net is out of the question. Bad reviews.
So there is really only one...Anthem EPO.

And as I have posted before this Anthem EPO's network is very limiting. We will have to give up all of our other doctors and only use UCSD.
With my current employer-based Anthem POS (PPO) we are not limited.

--

Protect Californians' Choice of Doctors: A Public Appeal to the California Insurance Commissioner and the Executive Director of Covered California

Dear Mr. Jones and Mr. Lee,

I am writing to request your immediate attention and intervention to assure the promise of the Affordable Care Act does not become a nightmare of deeply angry and horrified Californians cut off from the doctors who have cared for them for many years.

Many Californians are about to find themselves locked out of the anticipated benefits of health reform's new individual guaranteed acceptance health plans. Insurers are developing new restrictive provider networks--the list of doctors and medical facilities where policyholders can receive medical care. New buyers, which will include all individual buyers who purchased coverage after the passage of the Patient Protection and Affordable Care Act in March 2010, will find that their policies drastically restrict their choice of doctors.

MORE:
http://www.huffingtonpost.com/susan-shargel/protect-californians-choi_b_4158146.html

[Hoyt]

31. Limiting networks has been going on long before Obamacare. And in many cases it is docs

who are refusing to participate.

[SHRED]

33. 65%??

Blue Shield will offer only limited network Preferred Provider Organization (PPO) and Exclusive Provider Organization(EPO)plans to all new individual buyers. All new customers who have been anticipating purchasing guaranteed issue individual insurance for themselves and their families, will have access to a network that excludes 65% of current Blue Shield doctors and all the University of California Medical Centers.

Network access will be determined by county of residence. In Marin and Alameda counties, for example, Blue Shield plans to use an Exclusive Provider Organization (EPO). Buyers will find their access to medical services restricted to the doctors and medical facilities within the EPO in their county or an EPO doctor in another county. If the policyholder crosses the Golden Gate Bridge or Bay Bridge to consult with a San Francisco PPO doctor, s/he will have no insurance. If a San Francisco resident moves to Alameda, s/he will not be able to keep her San Francisco doctors.

It appears that carriers are also able to exclude residents of specific zip codes from access to their insurance plans. If one carrier can exclude residents in certain zip codes, what is the rationale to require other carriers to cover residents in that same zip code? The ACA requires insurers to accept all applicants regardless of health conditions. But California is allowing exclusion by residence location.

http://www.huffingtonpost.com/susan-shargel/protect-californians-choi_b_4158146.html

[Hoyt]

34. Where I live, hospitals are refusing to participate with some plans because they are greedy.

[Thinkingabout]

36. In a few years when the hospitals are not getting enough business they will change their business

plan. They will probably be charging more for their services and price themselves out of business. There will not be enough self payers to pick up the slack. I have been informed to locate another plan for 2015 to replace the retirement benefit I currently use. I will not be the only one. Even in the past years there has been negotiating between the insurance companies and providers and to the point of informing the insured to locate other facilities.

[hibbing]

40. Get the government out of my Medicare!

Heard that several times by some of these clueless people that have succumbed to the relentless lies and propaganda broadcast on the corporate media about the ACA. I will never understand how the right has been so successful at getting people to vote against their own economic self interests.

Peace

[Beartracks]

8. Obama-haters seem to think that "Obamacare" is some kind of govt-run insurance company.

Like, there's Aetna, Blue Cross, Obamacare, etc., and that the law is going to force everyone to "purchase their insurance from Obama."

Big. Eye. Roll.

But that right wing talking heads foster that impression, because it suits their tale about the "government takeover of healthcare."

===============

[CBHagman]

19. The phrase "government-run health care" was picked up by a pollster.

Robert Draper, in his book When the Tea Party Came to Town (original title: Do Not Ask What Good We Do), says that pollster Frank Luntz heard someone describe the Affordable Care Act that way and that the GOP ran with it.

[Saphire]

25. this. I've had to explain to three people

This week that the website gives you access to many insuronce compans and YOU choose the one you want. That's all. I deal with my new insurance company now...not the government.

[roguevalley]

9. lack of information is going to kill people. I am glad for them. Life is hard enough

[SHRED]

10. When you realize the limited coverage...

. ..by plans in the exchange it goes from a "godsend" to an OMG.


http://www.democraticunderground.com/10405186

..

[Hoyt]

32. If you don't have insurance, the network that will take you is even smaller.

[Martin Eden]

11. How many others would benefit from the Affordable Care Act ...

... but have swallowed all the false memes from the partisan hacks on the right?

The Rethugs desperately want thwart success of the ACA to help them win the midterms and if the initial attitude of the Riccis is any indication, that strategy has been pretty successful.

[Curmudgeoness]

12. Sooner or later, the anti-Obamacare crowd

will get coverage. And at that time, they will be like the Ricci's.

And the more people learn that they have been lied to by the Republicans and Foxy "News", the better is gets for us.

[ProSense]

17. Yes, that is the biggest fear of the liars. n/t

[Fred Sanders]

13. The millions that will will suffer needlessly in the Red states because of GOP Hate Politics

should be in the streets with pitchforks......if only they were not so misinformed and propagandized to the point of stupid.

[Shandris]

14. It is very, very difficult to not be 'misinformed and propagandized' 'to the point of stupid'...

...when you're barely scraping by to begin with (which would be, you know, -everyone- who would gain under increased Medicaid). You might take that into consideration when choosing how to describe those people.

My people.

Me.

Thank you.

[maddiemom]

18. Amazing how many uninformed citizens really believe that "we have the best healthcare in the world!

People come from all over, etc......" Uh...a little more complicated for our own citizens.

[Thinkingabout]

30. My friend fell and broke her ankle in France in July. She went to a medical facility

Saw a doctor who referred her to an orthopedic specialists, had a cast placed and out within 3 hours at a cost of $36. When she returned to the US it took 12 days to be referred and to see an orthopedic with a co-pay of $35. If she was a French citizen the cost would have been $8.

French citizens pays $10 month or $30 a month for a Cadillac policy. There are not any executives to pay or many people to file claims as we have here.

[TxDemChem]

16. Hell yeah!

[Jamaal510]

20. Obamacare: Making new fans one day at a time. nt

[Number23]

21. K&R Anyone that didn't see this coming should get in touch with me

I've got a bridge to sell. Order by February 1 and get our 18% New Year's discount.

[mstinamotorcity2]

38. Don't forget the once a

year fireworks special included included in your package I mean it may speed up the sale. You know how people love bells and whistles

[Cha]

22. I hope "Stephanie" understood in the

end that it was in fact "Obamacare" that she thinks is such a "god-send"!

Thanks PS~

[Berlum]

26. Republicons are shooting themselves in the foot with their mindless campaign against ACA

Talk about a losing issue. The repubbies really can pick 'em.

[riversedge]

27. I personally know several people here in WI who fall in that Medicaid gap that

the OP mentions. Our #teaparty Gov 'ultrasound' Walker has refused expanded Medicaid and 92, 000 folks will be kicked off of our Badgercare (WI version of Medicaid). He says they will go on Obamacare but here the premiums are high as are the deductables. A few work at Walmart, two as caregivers for the developmentally disabled--none have insurance thru their work and wages barely pay the rent.

The are left out!



..As Brill points out, if the Riccis had been living in Texas, where Sean got cancer treatment, or in any of the other states that refused Medicaid expansion, they'd still be screwed. They'd be in the Medicaid gap that millions of Americans, many with health issues as critical as Sean Ricci's, have fallen into. That's the kind of situation that the Affordable Care Act was supposed to end for everyone. It was supposed to mean. Thanks to the Supreme Court and an intractable Republican party that has invested more into fighting Obama than into fighting for their constituents, being able to access and afford health care is still a matter of luck.

http://www.dailykos.com/story/2014/01/17/1270505/-From-I-don-t-want-any-part-of-Obamacare-to-It-s-a-godsend

[spooky3]

35. Great story. Our new Gov. McAuliffe is working hard in VA

To get the Rethug legislature to see the problem this way:

"Why are you letting the fed govt take VA taxpayer dollars to help people in other states, rather than expand Medicaid and keep those $ at home to help your constituents and pay our providers?"

It's terrible that a simple appeal to legislators' empathy for the disadvantaged and the right to a reasonable level of health care doesn't suffice, but I like his economic and political framing of the issue.

[mstinamotorcity2]

37. I have family and friends who now

have health coverage thanks to the ACA. They are not hesitating to tell others about having insurance and Obamacare. They love it. this is how the Obamacare meme is shut down. As more people get insured, they tell others. Those people and hospitals in other states who are not participating in the ACA because of willful stupidity, will push for expansion. The one thing a republican can't stand is liberals having all the fun. Ask Alabama.

[Bernardo de La Paz]

39. Must play up big Red state denial of Medicaid coverage. It hits people very hard. nt

[ProSense]

41. Yup. n/t