Another View - Betsy McCaughey: The Obamacare horror stories are not liesBETSY McCAUGHEY
March 06. 2014 10:18PM
“Lies,” Senate Majority Leader Harry Reid calls the TV ads that feature people complaining about Obamacare. Sorry: The people in those ads are sick, but their new health policies don’t let them see the specialists or get the medications they need.
These patients aren’t liars; they’re people President Obama claimed he would help, who instead are being harmed.
They had insurance, but their plans got canceled because of the Affordable Care Act, forcing them into Obamacare. Now they’re discovering that Obamacare plans aren’t for sick people. They offer “free” mammograms, “free” colonoscopies and “free” contraceptives — meaning you don’t have a copay. But if you have cancer, MS or Parkinson’s, you’re in trouble: Most Obamacare plans skimp on specialists and life-saving drugs.
Dr. Jeffrey English, a Georgia neurologist who treats patients with advanced MS, worries that such patients forced into exchange plans will deteriorate rapidly. Some plans don’t cover six out of the 10 drugs that can treat MS, including the ones most effective at staving off irreversible paralysis.
“Obamacare is a throwback to the old HMO model of the 1990s, which promised a broad package of coverage for primary-care benefits like vaccines and routine doctor visits. But to pay for these benefits, the Obamacare plans skimp on other things, principally the number of doctors you’ll have access to and also the number of costlier branded drugs,” explains Dr. Scott Gottlieb, a practicing physician and fellow at the American Enterprise Institute.
It’s like a car with leather seats and Bose speakers, but a lousy engine. Another aspect of this approach: Most exchange plans exclude the academic medical centers that cancer patients look to when their local hospital runs out of answers.
Dr. Katherine Albrecht developed stage 3 breast cancer (which had spread to her lymph nodes) in 2011. Doctors at her local hospital in Nashua, N.H., told her to get her affairs in order. But her Anthem PPO health insurance allowed her to go to Dana Farber Cancer Center in Boston, where she was successfully treated, and afterward to Cornell Breast Cancer Center.
Her Anthem policy was canceled late last year because it didn’t meet Obamacare mandates such as maternity coverage. Yet Obamacare-compliant policies in New Hampshire won’t cover care at 10 of the 26 hospitals in the state, and none outside the state — so if she’d been on Obamacare when she got cancer, she couldn’t have gone to Boston for care. Albrecht says, “Under Obamacare, I’d be dead.”
Recently, the President urged Organizing for Action volunteers to enroll as many people as possible in Obamacare before the March 31 deadline, calling it “God’s work.” Really? Maybe helping the uninsured is God’s work. But not convincing people with health problems to move into plans that won’t provide the care they need to stay alive. In the private sector, that would be fraud. It takes politics to a new low.
In February 2013, the Obama administration whacked people with pre-existing conditions even harder by suspending the cap on out-of-pocket expenses under an Obamacare policy, which was originally set to kick in Jan. 1 at $6,350 for an individual. Theodore M. Thompson, a vice president of the National Multiple Sclerosis Society, said “The promise of out-of-pocket limits was one of the main reasons we supported health-care reform.”
Without the cap, an MS patient on Copaxone, which costs $6,000 a month, will have to spend about $1,500 to $2,000 every month for the copay on that one drug alone. That’s unaffordable for many.
Before the Affordable Care Act, nine out of every 10 Americans with pre-existing conditions had coverage. They got it through an employer-provided plan, Medicare or Medicaid without discrimination. Only the individual-policy market let insurers charge sick people more or turn them away — and even in that market most got covered. Nationwide, only 2 million to 4 million people with health problems couldn’t get coverage. That’s about 1 percent of the population — a small, fixable problem.
But Obamacare doesn’t fix the problem, it makes it far worse. As millions lose on-the-job coverage this year or next and get pushed into Obamacare, those with pre-existing illnesses will have the same difficulty getting care as the patients in the TV ads. It’s no lie.
Betsy McCaughey is a former lieutenant governor of New York. She is author of the new book, “Beating Obamacare:2014.” Her website is www.BetsyMcCaughey.com.