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Tuesday, November 5, 2013

The Fog Of Health Reform. Why There's So Much Bad Information About Obamacare

(Photo by Andrew Harrer/Bloomberg)
(Photo by Andrew Harrer/Bloomberg)
By Ezra Klein, Published: November 5, 2013
A week ago, Dianne Barrette was the poster child for the harms of health reform. Barrette is a 56-year-old Floridian who found she wouldn't be able to keep her health insurance after Obamacare. From the the transcript:
Last month, [Barrette] received a letter from Blue Cross/Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she’s being offered would run $591 a month, ten times more than what she currently pays. “What I have right now is what I’m happy with, and I just want to know why I can’t keep what I have. Why do I have to be forced into something else?”
Barrette's wrenching story quickly made Fox News, and then ricocheted through the rest of the media. Then the Washington Post's Erik Wemple called Barrette and got the details on her health-care plan.
Her current health insurance plan, she says, doesn’t cover “extended hospital stays; it’s not designed for that,” says Barrette. Well, does it cover any hospitalization? “Outpatient only,” responds Barrette. Nor does it cover ambulance service and some prenatal care. On the other hand, says Barrette, it does cover “most of my generic drugs that I need” and there’s a $50 co-pay for doctors’ appointments..A middling hospital stay could well have bankrupted Barrette under her current insurance.
Then the New Republic's Jonathan Cohn called Barrette and walked through the subsidies she'd qualify for and the precise plans she might be able to get. Her response? "I would jump at it," she told Cohn. "With my age, things can happen. I don’t want to have bills that could make me bankrupt. I don’t want to lose my house."
In the space of about a week, in other words, Barrette went from Obamacare victim to Obamacare beneficiary."Maybe," she said abut Obamacare, "it’s a blessing in disguise."
Call this the fog of health reform: We're in a period right now where the information coming out about the insurance people will get under Obamacare is often incomplete, wrong, or misleading. This is true for a few reasons:
1) People are getting cancellation notices from insurers, many of which include misleading quotes for how much replacement insurance will cost. (Read Dylan Scott's excellent investigation on this.) As Brian Beutler writes, "the media has fallen into a lazy habit of taking insurance companies at their word."
2) HealthCare.gov still isn't working that well, so people can't see their options under the new law.
3) The problems with the law's digital architecture have biased the media towards believing bad news about other parts of Obamacare.
Readers know that I think the problems with HealthCare.gov are real, and even severe. But I'm much more skeptical of the stories about people seeing their health insurance change. As Barrette's story shows, many of those cases will end with people in better, cheaper, more protective plans. That won't be true in every case, of course. But ending the days when healthy people got cheap plans because sick people couldn't buy any insurance at all is necessary, even if it's painful.
One year from now, the insurance market is likely to have settled, with a lot more people getting health insurance. That's not to say everyone will be better off. But it is to say a lot of people will be better off. The fact that we're not hearing from any of them yet is understandable given the problems with HealthCare.gov, but it's a problem for people trying to extrapolate from the coverage right now to the future of the law.

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