An op-ed in today’s Wall Street Journal by a California woman named Edie Littlefield Sundby has attracted a great deal of attention: She has survived stage-4 gallbladder cancer for seven years now, and she credits her doctors at UCSD, Stanford, and M. D. Anderson Cancer Center in Houston for much of her survival. But also crucial has been her individual insurance plan, with UnitedHealthcare in California, a preferred-provider-organization (PPO) plan that allows her to see out-of-network specialists. But UnitedHealthcare is now pulling out of the individual market in California, citing the Affordable Care Act, so she’ll have to purchase a plan from another insurer, likely on California’s state-run exchange. Even with the help of an insurance broker, she hasn’t found a suitable plan over the last month, and her options don’t include PPO plans, for the most part. Only one plan, for instance, includes access to UCSD, the hospital she’s used closest to where she lives.
Not content to admit that the ACA involves any tradeoffs whatsoever, the Center for American Progress’s ThinkProgress thinks it’s found a way to spin it, headlining a blog post ”The Real Reason That The Cancer Patient Writing In Today’s Wall Street Journal Lost Her Insurance.” Spoiler alert: It’s Obamacare.
TP’s Igor Volsky writes, ”Sundby shouldn’t blame reform — United Healthcare dropped her coverage because they’ve struggled to compete in California’s individual health care market for years and didn’t want to pay for sicker patients like Sundby.” Getting more specific, Volsky cites the company’s own reason for leaving the market, as if it serves his case: “The company’s plans reflect its concern that the first wave of newly insured customers under the law may be the costliest. UnitedHealth will watch and see how the exchanges evolve and expects the first enrollees will have ‘a pent-up appetite’ for medical care. We are approaching them with some degree of caution because of that.”
It’s almost amusing that Volsky thinks that explanation, delivered by United’s CEO to investors in 2012, says anything other than that the insurer left the market and ended Sundby’s plan because of Obamacare (I suppose Volsky could argue the company was lying to its investors about this fairly clear situation — he doesn’t). United was concerned about what the ACA would do to the individual insurance market (last year, even before it became clear that the insurance exchanges — even California’s — weren’t working that well and will probably see an even sicker, costlier mix of enrollees than expected), so it left.
Volsky concludes, “Sundby is losing her coverage and her doctors because of a business decision her insurer made within the competitive dynamics of California’s health care market” — as distorted by Obamacare. Volsky cites a couple other reasons why United has struggled to succeed on the individual market in California, but they’d stuck around – they’re now departing is because they think, at the margin, the ACA will make it the individual market a business they don’t want to be involved in (and like I said, given the exchange’s performance, they’re probably more right than they imagined).
Volsky says this makes United greedy and selfish: ”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, despite his headline, they made this greedy decision based on what the ACA is doing to California’s health-care market. There are millions of winners and losers under the ACA, a reality the president and all of his allies lied about when selling the plan. Now only the most disingenuous defenders are denying it — they happen to include the president, his press secretary, and a guy named Igor Volsky.