Friday, November 8, 2013


"I am sorry that they are finding themselves in this situation based on assurances they got from me" is as much of an apology from President Obama as we're likely to get. This apology isn't abject but it's a remarkable turn around from the president's previous wholehearted support of the Affordable Care Act (ACA). It's a far cry not only from his June 2009 promises but also from his September 25th statement in Maryland where he ringingly declared, once again, that "if you already have health care, you don't have to do anything."

By now we know that millions of  policy holders have been skunked because private plans purchased directly from insurance companies have been arbitrarily and unilaterally cancelled by the insurance companies that so eagerly sold them in the first place. These plans have conveniently been declared non-compliant with the ACA. The convenience is that the same companies can now turn around, create ACA-compliant health care plans, and sell them to their own customers at a hefty mark-up. It may not quite be double-billing, but it sure as Hades qualifies as "double-selling."

Here's what another one of our knowledgeable sources says:
"It's not the ACA doing this, it's the insurance industry using the ACA as an excuse to institute more advantageous plans for themselves." Right on! Too bad the president and his devoted inner clique didn't tumble to that in time  or didn't speak out. In fact, that millions of people would lose their health-care plans was actually reported in the Federal Register in June of 2010. Therefore, the obligation of public disclosure was technically met. Too bad, isn't it, that President Obama and Secretary Sibelius didn't read it or decided to ignore it while they steamrolled the public instead.

Our source whom we'll call Josefina points out that "the insurance companies were allowed to set up and offer whatever they wanted as long as they include no cap, no discrimination for pre-existing conditions, and some basic care inclusions such as maternity care and mammograms."

In fact, given these required inclusions, it can be argued with reasonable medical assurance that the ACA-compliant policies are probably superior to the plans that are now being pulled off the market. On the other hand, the buyer lost his choice of product.

Here's what happened to Josefina: first, Blue Cross cancelled her  health care plan. Blue Cross blamed the ACA. Then Blue Cross told Josefina they would send her a replacement policy that needed to be accepted by December, 2013 "in order to delay implementation of the ACA provisions at the same rate of $1427/month. They made it sound like that would be a good thing for me when the advantage is all theirs, including being able to max me out of my plan." A reasonable argument can be made that Blue Cross is complying with the ACA by offering a superior replacement policy even though such plans in the future are expected to cost more.

Josefina, who understands insurance, pointed out how the new plan could be ACA-compliant while also decreasing other coverage included in her previous plan but which isn't mandated by the ACA. By now our reading public knows that the ACA compliant plans include mandatory coverage of mental illness and maternity care even for 60 year old grandmothers. So the public finds it has to buy superior plans that cost more in order to cover the previously uninsured population estimated to be around 22 million persons.

Here's Josefina's summary: "They (the insurance companies) blame it on the ACA (Obamacare) but it actually (is) the insurance company industry manipulation while pretending that it's the ACA." 

Our conclusion: we agree with this assessment but feel obliged to point out that the Federal Government knew about the scam as early as June of 2010 -- that's when the president and Secretary Sebelius should have told the rest of us what was cooking in a pot that was shortly to boil over and burn millions of people who believed the presidential assurances from as early as 2009 and as recently as September of 2011.

One can only be dismayed at such deception unless we buy the argument  that the president and his staff were simply incompetent. Remember, this president is the same one who also promised in a speech on health reform in 2009 that he would make sure that "no government bureaucrat gets between you and the care you need." 

Although President Obama admitted that "we weren't as clear as we needed to be in terms of the changes that were taking place," he did not acknowledge that he knew at the time, or should have known at the time, that millions of persons would lose their private healthcare plans. Now we see a welcome reversal of field: "we've got to work hard to make sure that we're going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this." Our information is that the president has instructed his staff to "close some of the holes and gaps in the law" and to find out to what extent he can help as many persons as possible who lost their insurance.

Is that a promise to interfere with policies that foist insurance plans on us that we don't need? Sometimes there's no winning strategy. Instead, there's  a chance for restorative damage control. That could be the ultimate winning strategy in this otherwise fiasco of healthcare reform.


"User's Guide to the Affordable Care Act (Obamacare) and the Independent Payment Advisory Board (IPAB)," 6/28/2012,

"What Obama should've said about health reform," The Hill, Washington, D.C., 9/16/09

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