President Obama calls them “substandard” insurance plans. But to many of the people who bought individual insurance policies that are now being canceled under the Affordable Care Act, their choice of insurance was a prudent decision that met their needs at a price that will be hard to beat under the ACA.
Jim Stadler is one of the “5 percenters”—the 5% of Americans with health insurance policies they purchased on their own—who got notified recently that their carrier was canceling coverage because it didn’t meet the tougher new minimum requirements of the ACA. Stadler, a freelance writer who lives outside of Charlotte, N.C., was laid off from a full-time job at an ad agency in 2009, at which point he became a freelancer and bought individual health coverage for him and his two kids.
Under Stadler’s expiring policy, his premiums are $411 a month, for coverage that always seemed adequate to him. “It’s not a substandard policy,” he says. “I thought it was a great deal.” The premium for the new policy offered by his insurer will be $843 a month, with coverage that’s more or less the same as far as he’s concerned. But new policies are required to include free preventive services such as mammograms and colonoscopies, and they can’t be canceled or priced higher for sicker people, which is why the cost of some policies is going up.
Since Stadler’s family’s income is too high to qualify for federal subsidies, he’s considering putting his kids on the policy his wife, a teacher, gets through her job. But that would be expensive, too. “The thing that gets me,” says Stadler, who voted for Obama in the 2012 presidential election, “is I thought Barack Obama was the only guy I could trust in Washington. He ended up lying to me because he said, if I like my insurance, I could keep it.”
The 5-percenter problem could end up being a much more serious albatross for Obamacare and its mostly Democratic supporters than the notorious web site snafus and other temporary snags, which can mostly be fixed. Obama did, in fact, say repeatedly, “If you like your health insurance, you can keep it.” But policies held by as many as 10 million Americans don’t meet the minimum requirements of the law and are now being canceled. Obama this week added a “vast majority” clause to his earlier claim: “For the vast majority of people who have health insurance that works, you can keep it,” he said in a recent speech on health-care reform.
Obama also continues to point out that many people whose insurance is being cancelled will get a better deal through one of the new exchanges, because of federal subsides offered to lower-income people to help them pay for coverage. The real losers, by contrast, are people like Stadler who won’t qualify for subsidies, and will no longer be able to buy “substandard” policies, either. Many such people will face higher costs for better coverage they wouldn’t choose to pay for on their own, which is exactly the type of Washington-knows-better policymaking that outrages Tea Partiers and many independents who think the government has become too invasive.
Distrust of Obamacare and the people running it has been compounded by the malfunctioning web site and the sheer complexity of the law and its many requirements. Jeanne Patterson of Drexel Hill, Pa., will be losing coverage at the end of the year, and her insurance carrier told her she must choose another plan by Nov. 20 or she won’t be able to get coverage for 2014. The White House, meanwhile, has said it may take until Nov. 30 to fix the crash-prone federal web site. The ACA gives people who choose a plan through an exchange until Dec. 15 to purchase coverage that would take effect Jan. 1, but like many others, Patterson hasn’t been able to navigate the buggy site to find out what her options are.
Patterson, a 58-year-old unemployed insurance broker, pays $500 a month for insurance now, plus about $100 in co-pays for three brand-name medications used to treat chronic migraines. She might qualify for subsidies under the exchange that would help lower her premiums, but she worries that her out-of-pocket costs for drugs will skyrocket. “I had a really good plan,” she says. “My main problem now is uncertainty. It has me sick. I don’t know whether or not I’ll have health care and I don’t know what it will cost me.”
Obama and his supporters have characterized many people who buy individual insurance policies as dupes who don’t realize they’re paying exorbitant prices for an inferior product. In his recent speech, for instance, Obama described such coverage as “cut-rate plans” offered by “bad-apple insurers” that “don't offer real financial protection in the event of a serious illness or an accident.”
But many of the 5-percenters Obama is referring to see a cruel irony the president may not be aware of. “They canceled my insurance, then said, ‘Hey go get yourself some insurance, and if you don’t, we’re going to fine you,’”says Nate Quarry, a 41-year-old former mixed martial arts fighter who lives outside of Portland, Ore., and whose insurance will expire at year-end. Quarry was happy with the $650-a-month plan that covered him and his daughter. He doesn’t qualify for subsidies, so he’s been looking for a new individual policy similar to the one he’s losing.
So far, the insurance companies he’s called and emailed don’t seem interested in covering him. “I feel like I’m standing on a used car lot saying I want to buy a car, and nobody’s looking at me,” Quarry says. “Is this really happening?” Once the dust settles from the turbulent Obamacare launch, maybe an insurance company will step forward to take his money.
Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.