The Wall Street Journal caused quite a stir this week with an op-ed from Edie Littlefield Sundby, a California woman whose private insurer is poised to end her coverage. Because Sundby is a cancer survivor with access to great care, the right immediately seized on her case as the ultimate “Obamacare victim,” and she was rushed onto Fox News. This woman, we were told, is in grave danger because of the Affordable Care Act.
The details, however, matter. Sundby’s insurer, United Healthcare, is pulling out of the individual market to save money – something that happened routinely before the reform law was signed – and the company decided there’s far less profit to be made covering sicker patients like her. As Igor Volsky explained, “The company packed its bags and dumped its beneficiaries because it wants its competitors to swallow the first wave of sicker enrollees only to re-enter the market later and profit from the healthy people who still haven’t signed up for coverage.”
But what about Sundby going forward? What will this Obamacare critic do now? Volsky has a follow-up piece today, noting that under the Affordable Care Act, Sundby will fare rather well.
Relying on PacifiCare’s base rate filings with the California Department of Insurance, ThinkProgress estimated how much Sundby and her husband (who is on the same plan) could be paying for a high-deductible PPO in the individual health care market in 2013. We grew the base premium filed by the company by a conservative 40 percent to account for underwriting – the process by which insurers increase premiums to account for beneficiaries’ health profile. (On average, PacificCare increases base premiums by as much as 50 percent and given Sundby’s high medical expenses, her policy was likely heavily underwritten.) We also assumed that the couple hit all maximums in accounting for the average annual cost, estimating that they will pay approximately $37,000 for health care by the end of 2013.
And where does that leave Sundby and her family? With a choice of plans in California in which she’ll save thousands of dollars a year in premiums, have a lower deductible, and gain coverage that can’t be taken away. Indeed, in addition to saving money, Sundby will gain the new consumer protections that will strengthen her health security.
Remember, this story wasn’t cherry-picked by ThinkProgress to make the Affordable Care Act look good; this story was cherry-picked by the right to make the law look bad.
In this “horror story,” we’re talking about a consumer who’ll pay less for better insurance and greater security. It’s these relevant details that didn’t seem to make the cut in many of the reports this week.