Obamacare horror story debunked by Seattle Times columnist

[Galraedia]

Source: Raw Story

A Seattle Times columnist took a closer look at a conservative headline-making health care reform case Friday and discovered that the Rush Limbaugh narrative doesn’t hold up under scrutiny.

In Danny Westneat’s piece “Debunking Obamacare sob story,” the writer checked on the reversal of fortune claimed by Jessica Sanford, a Washington parent of an ADHD-diagnosed child, who had been touted by President Obama last month as an example of the success of the Affordable Care Act because she could obtain insurance for the first time in 15 years.

When Sanford said on a Facebook post that the state had miscalculated her eligibility for a subsidy based on her income and that she was “screwed,” the media pounced, particularly conservative outlets like Fox News and Rush Limbaugh.

However, Westneat’s examination revealed that Sanford’s son qualified for Medicaid coverage at $30 a month, which would have not been available before the ACA. “He has ADHD and, according to Sanford, it costs them $250 a month for prescription drugs alone. Which will now all be covered,” Westneat wrote. While Sanford had originally been quoted for coverage at $169 a month, a bronze-level policy for a 48-year-old woman making $49,000 costs $237 a month, while a silver-level policy costs $313, Westneat added.

Read more: http://www.rawstory.com/rs/2013/11/24/obamacare-horror-story-debunked-by-seattle-times-columnist/

[MiniMe]

1. I won't be holding my breath waiting for Rush to make the correction

[The Last Dem.]

2. No he won't

but big "Ed" will.

[freshwest]

3. Thanks, journalists still exist. It was a no-brainer, but MSM won't tell the truth.

[jtuck004]

4. So does this mean WA state will be taking back the 8000 letters they sent, including

the one to Sanford, which states that the calculations were incorrect. Will this reporter be "debunking" the other 7,999 and telling the state how wrong they were, and are?

The state says he does NOT qualify for Medicare and sent her a letter telling her this. This reporter says he does. Wonder who is going to win? The reporter also fails to note that "compounded" drugs are covered in hospital settings, but not necessarily at home. (I notice he cleverly substituted the word "prescription", but that's not what she said). And the state has acknowledged problems with the website, and that they are addressing them. Did the reporter use the screwed up website to make these calculations?

One of these reporters is a liar, or the situation is a lot less clear than either one of them is telling us. That does not detract from the fact that Rush Limbaugh is a big fat idiot, but it does lead one to believe that a lot of people are sticking their big fat noses in someone else's personal business after she was made a public example by the President, and many of them seem to only see what they want to see, regardless of the facts. Most of which are none of their business.

Thousands get wrong subsidies data from state health exchange
Washington Healthplanfinder said Friday that a calculator on its website mistakenly overestimated tax credits for about 6,000 applications that cover about 8,000 people.
By Amy Snow Landa

About 8,000 Washington residents who are purchasing health insurance on the state’s fledgling exchange marketplace may be getting less of a subsidy than they thought they had coming to help pay for it.

The exchange, called the Washington Healthplanfinder, said Friday that a calculator on its website mistakenly overestimated tax credits for about 6,000 applications that cover about 8,000 people, said Michael Marchand, communications director at the Washington Health Benefit Exchange, which operates Healthplanfinder.

“The exchange is very disappointed to have discovered this issue, and we find the situation unacceptable,” exchange CEO Richard Onizuka said in a statement. “Our staff will not stop working until we have notified all those affected and helped each and every one of our customers to ensure they have the correct tax-credit amount and can choose the best plan to meet their needs and budget.”

The discrepancy between the tax-credit amount that the website calculated for some people and the amount they are actually eligible to receive varies by applicant, said Michael Marchand, communications director at the Washington Health Benefit Exchange, which operates Healthplanfinder. “For some people, it’s pennies a month. For others, it’s much more,” he said.
...

Here.

[okaawhatever]

5. I believe the issue with her wasn't the amount of the subsidies, but that she didn't qualify

for them (because she qualified for medicaid). The issue is that many people are getting letters saying they don't qualify for the subsidies. The medicaid is government and the subsidies are private/public combination and each are handled by different people, so there can be a time lapse between finding out you don't get the subsidies and finding out it's because your income is below the threshold and you do get Medicaid. This happened more than once in the beginning. I don't think that has happened with people who sign up in person. While I don't doubt Washington state is having a problem with calculations, her claim was she signed up online and was excited about having insurance for the first time in years and then received a letter stating she didn't qualify for the subsidies. She said without the subsidies the plan was too expensive.

[jtuck004]

8. The original story said that her son was signed up for Medicaid, but then she got a letter

from the state saying he did not qualify for Medicaid, that it was wrongly calculated, and it detailed the problems she has had with that. Which, of course, changes the entire picture.

[SoapBox]

6. Compounded vs. prescriptions? For the son?

I don't see anything in the links about "compounding".

Or are you talking about something else.

[jtuck004]

9. In her story online that I read, it spoke of her son needing a compounded

medication every month, (it was posted here earlier, I think) but the reporter said "and, according to Sanford, it costs them $250 a month for prescription drugs ", which is a little different.

But set that aside, and the point is still that the state said she doesn't qualify. The reporter can disagree, but until the reporter has gone to the state and has proof that they are wrong, and has a letter in hand stating this, the state would seem to be more credible. The letters they sent out to thousands of people, including this one, say their calcs were wrong, and hers says she doesn't qualify for what the reporter said she did. This includes the report of the letter that says her son does not qualify for Medicare, apparently one of the known mis-calculations of the site, a mis-calculation which has been reported on fairly well.

I'll believe the reports by the state for now.

[tofuandbeer]

7. This is all so silly. We know who is behind all this bullshit.

We need stay on top of these bastards like keeping the kitchen clean to keep the roaches out. But I believe it will all soon pass, and ACA will be a part of living in the U.S.

Go to fucking hell GOP. You've failed to brainwash, hoodwink, and lie your way out of this one.

[blackspade]

10. Single-payer.

That is all.

[bread_and_roses]

11. ACA = Ghouls subsidized to batten on death & disease

None of this makes any sense to me ...

However, Westneat’s examination revealed that Sanford’s son qualified for Medicaid coverage at $30 a month, which would have not been available before the ACA.

For one thing, you don't "pay" for Medicaid coverage, at least in NY? Some people have a "spend-down" - ie, they are over-income by x$ and once they spend that on health care they qualify for Medicaid for other medical expenses in that month (or, at least, this is how it used to be; I have to qualify, it has been a good few years now since I worked in that system, and things have changed - but nonetheless, one doesn't "buy" Medicaid - it's an income-eligible program).

Secondly, are people here so detached from the reality of rent, food, utilities, transportation expenses, etc. as not to know that a single mother with a disabled child and an income of $49,000 yr cannot afford $237 a month for insurance? And that for piss-poor insurance, which is what "Bronze" people get?

The people that the ACA will help are those who end up heavily subsidized - by the commons, by all of us, by our taxes. I do not begrudge that and am happy for all who are helped. What I am NOT happy about is that the subsidy is not directly into medical care but into the pockets of the Insurance Ghouls, who actually provide no care for anyone. It's another transfer of wealth from the commons to the 1%, and that achieved by enshrining inequality of care based on what one can - supposedly - "afford." Bronze people! Vs "Platinum People!"

If you are choosing the "Bronze" package it's because you can't afford anything better - so how the hell are you supposed to pay the co-pays, etc. in the "Bronze" people category?

I am 63 years old - and still working. I have some fairly serious health issues. I am terrified that if something happens and I can't work, I will lose my employer provided coverage before I am eligible for Medicare. And even on Medicare, I don't know how I will afford the Supplementals and co-pays on what I'll have for retirement, despite working all my life since age 16. If I am knocked into the ACA pool if I can't work, I won't even be able to afford the Bronze - and if I could, one hospitalization and I'd be bankrupt anyway.

This is the reality of the ACA and of living in US if you're not rich. All so the Insurance Ghouls can fatten on our blood.

That posters here continue to celebrate this utterly baffles me.

[NYC_SKP]

12. Chosing the Bronze plan because "you can't afford anything better" would be a mistake.

And I think it points out the problem that people have in making sound health care decisions.

Sure, the premiums are lower for a bronze plan, but if you need a lot of services then it will cost more at the end of the year.

Thus, a bronze plan is a good choice for a healthy young person, all other things aside.

I fear that a lot of lower income people don't know how to make sound financial decisions, for example getting payday loans, and get deeper and deeper into debt.

I don't know this woman, all her details, etc., but it does seem that ACA is providing options she never ever had before.

I read about the 6000 people who got misinformation because the state website asked for monthly income and the federal site took that to mean annual income and calculated subsidies based on that error, and that makes sense as an error.

I trust it's all been worked out now.

[bread_and_roses]

13. So ... "lower income people don't know how to make sound financial decisions" eh?

Tell me, Skip - what's the "sound financial decision" when the choice is a payday loan or no heat in the winter? Especially if you have children, but I'd say even healthy adults would have a bit of a hard time with no heat during the last two nights in NY. I guess they're supposed to get up in a literally freezing house and wash in cold water for work? And what about the baby breathing that cold air?

And no, the "safety net" - especially as eviscerated as it was by Clinton, does not make sure these sorts of decisions don't happen for low-income people - not even always with children, and especially without children.

And are people really expected to go without food in order to buy the more expensive insurance? Because that's what you're recommending, seems to me.

I'm sure you don't mean it that way, but to talk about "sound financial decisions" is incredibly condescending when your resources don't stretch to food and heat.

[NYC_SKP]

14. Payday loans are never a good idea, quit trying to defend decisions to use them.

Especially in NY city which has aggressive protections for tenants who might have crappy landlords who don't provide heat or light or water.

It's a demonstrable fact that lower income people often have trouble making sound financial decisions, it's absolutely true.

I never said that it's easy or that it's fair, but it's still true.

Payday loans, sub-prime mortgages, all these sorts of things are literally targeted toward poorer people who have fewer choices.

ACA is not one of these.

If all they can afford on a tight monthly budget is bronze, let them have bronze.

If they are really strapped then the system is designed to give them subsidies. Results vary from state to state but Washington state is a good provider.

[bread_and_roses]

20. "Let them have Bronze ..."

... and let them eat cake, while they're at it

[Gormy Cuss]

15. Choosing the bronze plan because you can't afford the others is not a mistake.

It's the only option one has other than paying the penalty for not choosing any plan and therefore is the sound choice. You can't get blood from a turnip. If the money isn't available, there IS no option for the silver plan.

Payday loans are horribly expensive but they exist because there aren't better options for lower income people in a bind. They are lenders of last resort.

[NYC_SKP]

16. Clarification that should have been obvious: "Monthly premium should not the only criterion."

Going just by the premium COULD end up being expensive.

Just like going for the lowest monthly payment on a auto purchase could be a HUGE mistake (72 months, low payment, but longer term).

Short term thinking, "I just won't get sick" thinking is something that could cost more money later.

Of course, if after every belt has been tightened and there is no other way the Bronze plan is all one can afford then I guess you go with that.

But looking ONLY at monthly premium price is not making a sound financial judgment.

[Gormy Cuss]

18. However, if you know that you can't afford the higher premium, your choice is gone.

That's why financially strapped individuals make seemingly unsound financial choices -- because they don't have the luxury of making the "better" choice. If all you have this month is $80, you can't choose to spend $100. It's a sound decision to risk having more out-of-pocket expenses should you happen to get sick. You'll deal that problem when and if it happens (payday loan, anyone?)

Now for someone who can afford the higher cost plans, looking at all of the costs associated with each level before choosing is prudent.

[NYC_SKP]

19. All true, but please note the context of my first reply and the reply to which I am responding.

The poster is not happy with ACA, not one bit, thinks it's all a giveaway to insurance companies, etc., etc.

And I'm sympathetic to anyone who has health issues and living from paycheck to paycheck.

However, they wrote:

If you are choosing the "Bronze" package it's because you can't afford anything better - so how the hell are you supposed to pay the co-pays, etc. in the "Bronze" people category?

I am 63 years old - and still working. I have some fairly serious health issues. I am terrified that if something happens and I can't work, I will lose my employer provided coverage before I am eligible for Medicare. And even on Medicare, I don't know how I will afford the Supplementals and co-pays on what I'll have for retirement, despite working all my life since age 16. If I am knocked into the ACA pool if I can't work, I won't even be able to afford the Bronze - and if I could, one hospitalization and I'd be bankrupt anyway.

This is the reality of the ACA and of living in US if you're not rich. All so the Insurance Ghouls can fatten on our blood.

That posters here continue to celebrate this utterly baffles me.

To which I would say, sure, some can only afford the Bronze package if they are unwilling or unable to make cuts elsewhere, but at least they'd have coverage. AND most would probably be able to choose at lease a silver plan but might go with bronze because if they never had an insurance premium to pay it would seem like a new expense and hard to fit in, BUT these same folks probably didn't have ANY care before ACA so are being provided care that was never there before.

Moreover, the poster quoted above HAS and insurance plan through work, so I'm not sure what the rant is all about. They are afraid that they might get knocked into the ACA pool?

They are blessed with an employer provided plan.

I wish to hell I had an employer provided plan instead of a $1,439/month COBRA plan for just me.

That person doesn't like ACA and I replied to their claim about what people can afford.

What people truly can't afford is to not have healthcare at all and I'm glad we're moving toward insuring more and more people, and affordably so!

[geek tragedy]

17. Lots of people making less than $49,000 would LOVE to be able to buy insurance for only $237

a month.

I paid more than that when earning less than $30,000--and that was years ago.

I am 63 years old - and still working. I have some fairly serious health issues. I am terrified that if something happens and I can't work, I will lose my employer provided coverage before I am eligible for Medicare. And even on Medicare, I don't know how I will afford the Supplementals and co-pays on what I'll have for retirement, despite working all my life since age 16. If I am knocked into the ACA pool if I can't work, I won't even be able to afford the Bronze - and if I could, one hospitalization and I'd be bankrupt anyway.

This is the reality of the ACA and of living in US if you're not rich. All so the Insurance Ghouls can fatten on our blood.

That posters here continue to celebrate this utterly baffles me.

1) If you lose your source of income by losing your job, you'd likely be eligible for significant subsidies and possibly Medicaid;

2) Under the old system, if you lost your current insurance you'd be unable to get new insurance from anyone--they would simply refuse to offer you a policy due to pre-existing conditions. So, you'd have 0% coverage and would pay 100% out of pocket.

3) Medicare A&B do not provide great coverage. That's why people find themselves needing to supplement it with . . . insurance offered only by the Insurance Ghouls. Also, the claims processing for Medicare is performed by the Insurance Ghouls.

[Cha]

21. Thank you, Galraedia!