Still from "Julie's Story: It's Time to Listen" (youtube.com/Americans for Prosperity)

Are Republicans even trying? Another Obamacare horror story bites the dust

Given how horrible Obamacare supposedly is, it's bizarre the GOP has such a hard time finding real victims


Brian Beutler
February 21, 2014 5:43PM (UTC)

Given how horrible Obamacare supposedly is, it's a little bizarre that Republicans and their allies have such a hard time finding victims who are unambiguously worse off as a result of the law.

GOP leaders trotted out a woman named Bette during their official response to President Obama's State of the Union address. Once reporters with even rudimentary understanding of the law began poking around, they discovered that Bette was more a victim of anti-Obamacare histrionics than of the genuine article.

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The ad makers at the conservative pressure group Americans for Prosperity are the Jerry Bruckheimers of atmospherically devastating campaign spots attacking Democrats who voted for Obamacare, but like nearly all Bruckheimer films the plots of these ads fall apart upon the mildest scrutiny.

The "victims" in one of their ads attacking Sen. Mary Landrieu, D-La., turned out to be paid actors. Now in Michigan, they've found a genuinely sympathetic character -- Leukemia patient Julie Boonstra -- who seems to earnestly dislike the Affordable Care Act. But neither Boonstra nor AFP can quite put their fingers on why she's worse off under the law than she was before. That's not to say she should be an Obamacare fan -- who am I to tell her that? But there's almost no denying that she's more protected now than she was before, and probably better off financially as well.

Boonstra's central complaint is that she lost her old healthcare plan because of Obamacare, just like an untold number of other individual market patrons. But the ad also suggests very strongly that she lost her doctor as well, and has been saddled with significantly higher costs.

The Washington Post's Glenn Kessler beat me to the fact check. It turns out that she kept her doctor, and in a separate interview with the Detroit News, acknowledged that her premiums under Obamacare ($571 a month) are half as much as they were last year ($1,100). Her annual savings -- $6,348 -- are actually just $2 shy of the Affordable Care Act's $6,350 "Out of Pocket Maximum" for an individual plan, above which the insurance company must pay every penny.

Either she's unaware of that, or doesn't want to admit it, because she told Kessler, "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.”

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By "80/20," Boonstra's implying she has a silver-plated healthcare plan, but the 20 percent cost sharing only applies to costs incurred under the OOP maximum. Any individual on that plan who needed, say, a $100,000 bone marrow transplant tomorrow wouldn't owe $20,000 out of pocket. They'd owe $6,350.

AFP spokesman Levi Russell's response amounts to an observation that a higher deductible exposes patients to lumpier, more unpredictable costs. “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.’”

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More on that "quit complaining" objection in a moment. First, the numbers. It's true in theory that any ACA beneficiary -- whether a leukemia patient or an accident victim -- could be confronted with a bill for the entire OOP maximum immediately after obtaining coverage. Saving $6,348 over the course of a year doesn't help much if you owe $6,350 in February, and if your old deductible was much lower, and you had a low OOP maximum that would probably seem extremely unfair. But what I know from personal experience and previous reporting is that providers will generally work with patients -- create payment plans, allow them to pay in installments -- if they can't cover their full deductibles right away.

I don't know if Boonstra's physician won't do that, or if she's unaware that it's a common practice, but it more or less moots the unpredictable payment objection. And that's to say nothing of the fact that, thanks to ACA, Boonstra's carrier can no longer rescind her plan and can't hike her premiums due to her preexisting condition. When I attempted to phone her at home, I reached a non-voice-mail message: "Hello, we are not available right now. Please call again. Thank you for your call."

Russell did not return my email seeking further information.

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Given the track record here, though, his insinuation to Kessler that further interrogating these stories amounts to victim scolding is ludicrous.

Remember this ad?

It was every bit as devastating as Julie Boonstra's. But that didn't insulate it from scrutiny, and when scrutinized, it turned out there were a few more degrees of separation between Mitt Romney and the death of Joe Soptic's wife than the ad implied.

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By contrast, the AFP ad's central implications (lost doctor, higher costs) are apparently just fabricated.

I know the right is heavily invested not just in ignoring Obamacare success stories, but in cultivating the very horror stories they then use to attack the law. This, at least, doesn't appear to be a case of the latter. I'm perfectly willing to believe that the Affordable Care Act has really left some people in categorically horrible situations. Given the numbers involved, I'd be pretty surprised if such people didn't exist. But at some point it's worth asking whether the apparent difficulty conservatives have finding them suggests that maybe the law isn't wreaking all the devastation they want you to believe it is.


Brian Beutler

Brian Beutler is Salon's political writer. Email him at bbeutler@salon.com and follow him on Twitter at @brianbeutler.

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