WASHINGTON — A political ad that features a Dexter woman criticizing U.S. Rep. Gary Peters, a candidate for U.S. Senate in Michigan, for his vote in favor of the Affordable Care Act is coming under scrutiny from the Washington Post.
In its Fact Checker column, the Post’s Glenn Kessler vets the ad produced by Americans for Prosperity, a conservative group that has spent upwards of $1 million already in targeting Peters, D-Bloomfield Township, who is running to replace the retiring Sen. Carl Levin.
The ad features Julie Boonstra of Dexter, a leukemia patient who says her previous insurance , which she preferred, was canceled under the Affordable Care Act. She says that “the out-of-pocket costs are so high that it’s unaffordable,” and, “if I do not receive my medication I will die.”
Boonstra was a guest of U.S. Rep. Tim Walberg, R-Tipton, at last month’s State of the Union address as someone who had lost coverage because of the health care reform bill passed in 2010.
The Post, however, said AFP confirmed that Boonstra was able to find a new Blue Cross Blue Shield of Michigan plan that allowed her to keep her doctor and noted that under the ACA, individual plans have an out-of-pocket maximum of $6,350 a year, including medications.
Kessler quoted a report in the Detroit News saying the new plan’s premium was reduced from $1,100 a month to $571 — meaning that over the course of a year, Boonstra would save $6,348, or just two dollars less than the out-of-pocket maximum for the plan.
Pharmaceutical costs are included in the out-of-pocket maximum, meaning after that amount is paid, drugs are covered at 100%.
The Free Press was unable to reach Boonstra in Dexter at phone numbers listed under her name, and AFP spokesman Levi Russell did not immediately return a telephone call for comment. He told the Post that the costs of her coverage “have quickly become unpredictable” and that instead “of knowing exactly what she would have to pay every month, she now is facing a roller coaster of expenses.”
The ad, which has Boonstra saying Peters’ “decision to vote for Obamacare jeopardized my health” also leaves out Peters’ vote last year to allow insurers to keep selling individual policies that had been offered before the ACA went into effect.
http://www.freep.com/article/201402...xter-woman-washington-post-health-care-peters
http://www.washingtonpost.com/blogs...gops-obamacare-horror-stories-strategy-works/
The Facts
First of all, many viewers might think Boonstra lost her doctor, as she mentions her “wonderful doctor” and then says her plan was canceled. But AFP confirms that she was able to find a plan, via Blue Cross Blue Shield, that had her doctor in its network.
Local news reports recount that Boonstra, like many Americans, initially had trouble getting a plan because of the botched launch of healthcare.gov. No doubt that was a difficult experience. She then was invited by her local member of Congress to attend the State of the Union address and participated in a Republican National Committee news conference that highlighted problems with Obamacare’s stumbling launch.
At that news conference, Boonstra said, “I’m paying a higher cost now as far as out of pocket costs and the coverage is just not the same.” But in the new ad she says “the out-of-pocket costs are so high, it’s unaffordable.”
The claim that the costs are now “unaffordable” appeared odd because, under Obamacare, there is an out-of-pocket maximum of $6,350 for an individual plan, after which the insurance plan pays 100 percent of covered benefits. The Blue Cross Blue Shield plans in Michigan that appear to match Boonstra’s plan, as described in local news reports, all have that limit.
Meanwhile, Boonstra told the Detroit News that her monthly premiums were cut in half, from $1,100 a month to $571. That’s a savings of $529 a month. Over the course of a year, the premium savings amounts to $6,348—just two dollars shy of the out-of-pocket maximum.
We were unable to reach Boonstra, but on the fact of it, the premium savings appear to match whatever out-of-pocket costs she now faces.
Levi Russell, a spokesman for AFP, said he “would assume there is an OOP max, but this is the story of Julie, a real person suffering from blood cancer, not some neat and tidy White House PowerPoint about how the ACA is helping everyone.” He said there is a possibility that her specific chemotherapy medication will not be covered.
“Julie’s concerns about her new plan are ongoing and very personal. Since her out of pocket costs are so much higher now, her costs have quickly become unpredictable,” he added. “Rather than knowing exactly what she would have to pay every month, she now is facing a roller coaster of expenses that vary with her health. She said she feels like a surprise is around every corner, since she keeps being hit with new out-of-pocket costs every time she needs treatment, or a test, or even an office visit.”
He concluded: “Now her expenses are unpredictable, and that means unaffordable. It could be $600 one month, and three times that the next month. The reality of what she’s dealing with is much more involved and can’t be swept aside by saying, ‘you have an OOP maximum so quit complaining about your cancer.’”
The Pinocchio Test
The Fact Checker surely does not want to play down the emotional anguish that any cancer patient may face, but a fuller accounting is necessary if AFP is going to air ads like this. In order to properly compare the old plan and the new plan, there needs to be fuller disclosure of the costs and out-of-pocket maximums before claims that the new plan is “unaffordable” can be accepted at face value. Too many anecdotal stories, on both sides, have fallen apart under close scrutiny.
Russell passed along a quote from Boonstra: “My plan, the premiums are half, but the out‑of‑pocket costs are so high that for me, it’s unaffordable. My coverage is 80/20. Blood work, I’m paying 20 percent. If I needed a bone marrow transplant, I would only be covered 80 percent. Everything, everything I do now, I have to pay a percentage of.”
It is one thing to say there are higher out-of-pocket costs, as she did at the RNC news conference, but another to assume that those higher costs are not offset in some way by the significantly lower premium. The reality is that eventually Boonstra will hit the maximum and no longer pay anything. So over the course of the year, the difference in the costs could well even out.
http://www.washingtonpost.com/blogs...im-that-doesnt-add-up/?wprss=rss_fact-checker
So basically Julie’s Story is a lie. Julie gets to keep her physician. Julie has her "unaffordable" Obamacare" healthcare insurance. So obviously it wasn't that unaffordable. Her health insurance premiums are slightly more than $500 less than what she paid before Obamacare. But now she is responsible for out of pocket expense which could, underline could, increase her out of pocket costs by up to less than $500/month. So with Obamacare Julie's combined healthcare insurance premiums and maximum out of pocket expenses would cost slightly less than what she paid prior to Obamacare.
Subsequently Koch brother advocates argued that the uncertainty of the out of pocket expenses caused Julie undue duress. Welcome to healthcare insurance. That is they way it has always been. If the uncertainty of her out of pocket expenses is causing Julie undue stress and if Julie really wants to pay that additional premium, I have a number of charities that would be willing to accept it.
So Obamacare is actually better for Julie than what she had before. Her healthcare costs, even with the potential for increased out of pocket expenses is less that what she was paying for premiums alone prior to Obamacare and Obamacare has provided her with certain assurances/guarantees and no lifetime maximums which she didn't have before Obamacare.