Like many of you, I checked out the Obamacare exchanges today, specifically in my case Washington, DC’s. And it wasn’t bad.
I didn’t have any of the computer glitches that many apparently suffered in other states (problems creating the secret reminders was a particular problem), and I found two “platinum” plans that were quite interesting – one $90 more than I pay now, and one $40 less.
Now, I still have a LOT of work to do digging in to the plans more deeply. Like any health insurance, the devil is in the details, and after an hour+ on the phone with Blue Cross Blue Shield I’m still awfully confused as to how the two plans work in practice. (Meaning, it’s one thing to tell me I pay 10% of the allowed price for a day in the hospital under one plan, and $150 a day under the other, but what does that really mean for an average sickness, how much will it actually cost me – which one is the wiser option for me? I don’t really know, yet.)
Obamacare exchange is better than the plan I have now
But of course, each plan is still basically better than the coverage I have now, particularly in terms of its prescription drug coverage, which is next to non-existent in my current plan.
I simply can’t afford (physically) to keep my current grandfathered pre-Obama coverage. I mean, I CAN keep it. That’s the way Obamacare works. You get to keep your current coverage if you want (the Republicans lied about that point, a lot – today it was definitively proven to be untrue, just call your insurance company and ask them if you can keep your current plan). My problem is that my prescription drug coverage is limited to $1500 a year, which is not a large threshold once you reach a certain ago. If I ever get sick in any way that requires my buying any kind of expensive prescription drugs – and I mean really sick, like MS, HIV, or even a serious infection – I’m toast. HIV drugs can cost you $2,000 a month. And MS can be even more expensive. Who can afford $2,000 a month? (Oh that’s right, Republicans.)
I’ve been relatively lucky so far – meaning, my Rx drug costs have maxed at around $550 per month (I’ve cut those costs by buying cheaper drugs in Europe). Of course, only an American would call those kind of exorbitant prices “lucky.” Europeans recoil in horror when you tell them we pay this much for medical care in America. But I manage. My problem is that some day I may get sick and need really expensive drugs, antibiotics, or whatever, and that’s the day I’m in trouble under my current plan.
Until Obamacare came along, I was pretty much stuck in the plan I’m in, as no one would take me for any other plans with my pre-existing conditions. So my option without Obamacare was to stick with the expensive insurance I’ve got, and hope that the day never comes that I might need expensive prescription drugs (well, more expensive than my current $550 or so a month). And if that day did come, and I got really sick and couldn’t afford to pay for my treatment, I’d leave America all together and move to Europe in the hopes that with less expensive drugs I might live.
Of course, that day kind of did come already. My asthma doc wants to get me off of the steroids he’s had me on for five years now – long-term steroid use isn’t terribly healthy to your other organs, and in my case, I keep having “rare” adverse reactions to the steroids, like my early onset of cataracts (though, thank you, steroids, for giving me 20/25 vision post-surgery!) The drug he wants to put me on costs a little over $1,000 a month. A MONTH. That’s just insane. My old plan would cover one month of the drug per year. And while the new plan covers the drug, I still need to see to what degree – it’s possible that I’ll still be asked to pay $200 to $500 per month for just those 4 daily pills, and I’m not sure I can afford that. So the new plans are not necessarily a panacea. But under my current non-Obamacare plan, that $1,000 drug would cost me $1,000 a month. So the new plans are still an improvement over my current coverage.
Surprise! Under the Obamacare exchange, I do get to keep my own doctor
Another thing I found out today about my two potential Obamacare exchange lans: Under the plans, I pick my own doctors 100%.
One plan is a PPO style plan, the other an HMO/PPO hybrid that requires me to pick a primary care physician (and since my current doctor takes Blue Cross Blue Shield, I should be able to choose him). Under both plans I can pick whatever specialists I want, no referrals necessary. And so long as the doctors I pick are in-network, I get great coverage (better than I have now apparently). Out of network, which I don’t use a lot, I still need to delve into more to better understand what I get and don’t get.
But here’s the thing. I’m watching Crossfire on CNN tonight, and there’s far-right Republican Senator Tom Coburn – a “doctor” – talking about how under Obamacare you don’t get to choose your own doctor. And the thing is, I spent several hours today analyzing my Obamacare options, and I very much get to keep own my doctors under Obamacare. I called Blue Cross to confirm. Tom Coburn is a liar.
Under Obamacare, I can either: A) stick with my old insurance policy and keep my own doctor; or B) buy one of the plans on the Obamacare exchanges, and keep my own doctor. So what is Coburn talking about?
Here’s Senator Tom Coburn on Crossfire:
We’re gonna have the government run and decide what you will get, by the different plans, we’ve decided what you’ll get, rather than you decide. Here’s the thing that’s gonna happen. Here’s what people are gonna see: You’re not ever gonna see the same doctor, year in and year out under this plan, you’re never gonna have the same care, you’re never gonna have the same access.
On its face, an outright lie.
Republicans do better in the polls when they lie. That ought to tell them something.
As I’ve written before, Republicans learned long ago that they do far better winning the public over if they simply lie. If the Republicans actually told the American people that Obamacare would let them keep their current health insurance, but it would also provide them with additional options, that, if the price is right, they could buy instead of their current coverage, people would love it. So the Republicans lie.
Keep in mind that the most effective argument the Republicans came up with against health care reform was Sarah Palin’s lie about the bill containing “death panels” that would decide if elderly Americans live or die. It’s ridiculous, and a lie, and ended up working a lot better than the truth, so the GOP stuck with it.
It was truly idiotic for the Republican party to shut down the government over Obamacare on the day that the Obamacare exchanges go live. With the click of a mouse, every single American can go online and check to see if they can get a better plan under the exchanges, check to see if the Republicans are telling the truth or whether, like Tom Coburn, they’re just liars. If you’re going to tell a lie about something, don’t do it about something that’s so easily verifiable. Until today, no one could really confirm that things would be better under Obamacare. Now we know for a fact that for many Americans, it is.
In the end, I don’t know if I’m going to buy the plan on the exchange, but I suspect I will. I can only gamble so long with my health, and even though I can switch to an exchange plan at some point in the future if I get sick, I can only switch during the open season. But that might be too late if I’m really sick – I may not be able to afford to wait several months to change to a better plan. So I probably will switch now, but as I said, I first have a little more math, and a few more phone conversations, to run.
But what I do know after a day of researching my options on the DC Affordable Care Act exchange, and talking to Blue Cross until we were both blue (but not so cross) in the face, is that today I have more options than I had yesterday. And that’s not just a good thing, that’s a great thing.