Thursday, October 31, 2013

More insurance fraud

As you know, I'm collecting examples of people claiming they liked it and couldn't keep it and giving those claims a bit of a closer look. Today's (Happy Halloween!) Obamacare victim is Sue Klinkhamer, a 60-year-old former Democratic congressional staffer from St. Charles, Illinois:
When Klinkhamer lost her congressional job, she had to buy an individual policy on the open market.
Three years ago, it was $225 a month with a $2,500 deductible. Each year it went up a little to, as of Sept. 1, $291 with a $3,500 deductible. Then, a few weeks ago, she got a letter. [jump]
Photo by Chip Somodevilla/Getty Images, via Time.
“Blue Cross,” she said, “stated my current coverage would expire on Dec. 31, and here are my options: I can have a plan with similar benefits for $647.12 [or] I can have a plan with similar [but higher] pricing for $322.32 but with a $6,500 deductible.”
She went on, “Blue Cross also tells me that if I don’t pick one of the options, they will just assume I want the one for $647. ... Someone please tell me why my premium in January will be $356 more than in December?” (Chicago Sun-Times)
Sounds pretty harsh! But there's something a little odd about it, because:

Projected Obamacare Rates for an Individual, Age 60, in Saint Charles, Illinois

  • Lowest Catatrophic Plan = $464.94/mo

  • Lowest Bronze Plan = $322.10/mo

  • Lowest Silver Plan = $444.80/mo

  • Second Lowest Silver Plan* = $449.25/mo

  • Lowest Gold Plan = $521.82/mo

Abigail Lodge Care Home, Consett, County Durham, England.
So that $647 plan must be pretty ritzy! (It's the Blue PPO Silver with $3000 deductible, if you're interested.)  And she's been getting a comparable plan now for under $300? (If it had a $3,500 deductible it must have been the Blue Edge Individual HSA Premier PPO...) Lucky her! The situation for most Americans ages 50-64 trying to get insurance on the individual market was rather different--as AARP put it in February 2012:
  • Because most states allow health insurers to charge higher premiums based on age and health, adults in the 50-to-64 age group have difficulty securing health insurance coverage; more than one in five insurance applications from individuals age 50 to 64 is rejected.

  • For older adults who do purchase insurance plans on the individual market, the average out-of-pocket costs for premiums and health care are typically two-and-half times higher than the costs paid by people their age who have employer-sponsored coverage.
The average high-deductible employer-offered plan in 2013 would have cost her $450 a month, according to the Kaiser Foundation
Average premiums for high-deductible health plans with a savings option (HDHP/SOs) are lower than the overall average for all plan types for both single and family coverage (Exhibit B), at $5,306 and $15,227, respectively.
—and that average plan was no Silver plan, believe me. I can't find out what her Blue Edge Premier would have cost on the open market (they've all been cancelled and disappeared from the website calculators), but it was certainly well over $291, and almost certainly quite a bit over $450 as well; if she was really paying such a low premium she was getting a very remarkable deal, and I'd like to know why.

And then why isn't she covered on her husband's policy? He retired (with the rank of Commander in the St. Charles police force) in 2004, and under Illinois law
Public Act 86-1444 requires IMRF employers who offer health insurance to their active employees to offer the same health insurance to disabled members, retirees, and surviving spouses at the same premium rate for active employees. It does not require IMRF employers to provide health insurance which is not already provided. The same coverage, provisions, deductibles, etc. which apply to active employees apply to individuals receiving continued insurance coverage. This includes coverage for dependents of members who are insured under the policy on the day immediately before the day the member retires or becomes disabled.  
So there actually seems to be something a little fishy going on.

If so, it would not be the first time in the lives of Sue and Dan Klinkhamer. Way back when, before she became a Democratic ex-Congressional aide, was a time when she wasn't a Congressional aide, and she wasn't even a Democrat:
Klinkhamer’s voting record in Kane County shows she voted Republican in six primaries from 1996 through 2006. Then the record shows she voted Democratic in the special and general primary in 2008 and the 2010 primary. (Kane County Chronicle)
Happy St. Charles Town. Paul Chase Graphic Visions.
She was a nonpartisan alderman in St. Charles, as a matter of fact, where Dan was still working as a police sergeant, from 1989 to 1997, and subsequently mayor from 1997 to 2005, where she and Dan rubbed some people the wrong way and incurred a good deal of badmouthing, in a lawsuit filed April 2000
in Kane County Circuit Court, alleg[ing] city officials have schemed to control the Police Department for their own financial and political gain and have stymied several police investigations into illegal gambling, drug use, drug trafficking and sale of alcohol to minors. It also claims officials have accepted cash and gifts in violation of state law and have violated police rules prohibiting officers from hiring themselves out as private security guards. (Chicago Tribune)
and that the defendants
conspired to use the police department to their benefit and that police ... employees were unfairly, disciplined or denied promotions for raising questions about Klinkhamer or her husband. . .  (Daily Herald)
(The suit was settled, and I don't know about all those accusations, but Dan had certainly hired himself out as a security guard in 1992, serving since then until today as Director of Security for the Kane County Cougars minor league baseball club and their stadium, which hosts quite a number of moderately big-name concerts in any given year; and it was acknowledged that he was guilty enough of sexual misconduct to deserve the written warnings he received, just denied that he deserved additional discipline.)

And then in 2003 she fired her old co-defendant from the previous case, police chief Donald Shaw, and he turned around and sued her in his turn:
A week after stepping down, former St. Charles Police Chief Don Shaw filed a federal lawsuit against the city and Mayor Sue KUnkhamer, alleging he was fired after blowing the \vhistle on corruption in city hall. City officials vehemently denied the allegations. In the lawsuit Shaw, now a St. Charles sergeant, said Klinkhamer chastised him for ticketing McNally's Irish Pub for selling liquor to underage patrons during an undercover police sting because the bar is owned by a "close associate." Shaw also said he refused KJinkhamer's demands to nullify a traffic ticket for another ally, an unnamed local businessman. (Daily Herald)
This kind of broke her heart:
Former St. Charles Police Chief Don Shaw accused Klinkhamer of having him fired for pursuing charges against people he perceived as Klinkhamer's political allies.
In the filing, Shaw said he was pressured to drop a citation against the owner of a local tavern accused of selling alcohol to a minor and kill a traffic ticket written against another local businessman. The suit eventually was settled with more than $300,000 going to Shaw.... The lawsuit became a major issue in Klinkhamer unsuccessful bid for re-election in 2005. The loss sent her into a bout of depression. 
“I had tears in my eyes on like a daily basis,” Klinkhamer recalled. “It was only a $15,000 a year job, but being mayor was my life. And I was learning a lot about people then. That's why I don't ever want to get that invested money-wise because I will never forget how once you weren't mayor anymore that people just moved on from you.”(Daily Herald)
She was so upset she lost the 2005 election and found herself looking for a job. (We don't know whether Dan's retirement in 2004 had anything to do with the case, but maybe the police department wasn't a very pleasant place, with the ex-chief serving as sergeant and no doubt making nasty faces as Commander Dan sat at his computer working on his fantasy baseball outfit, the Santa Lechuga Power League.)
Image from The Sport Smithy.
She turned first to the Republican county board chairman, Karen McConnaughay, for a post as administrative assistant for which she seemed overqualified, but took a position in DC as a transportation lobbyist for the city of Chicago (Richard M. Daley, mayor), and then went to work for Democrat Bill Foster, when he won the special election for Denny Hastert's seat when the former Speaker suddenly resigned in 2007, and took up a new career as a congressional aide, at the age of 53.

Obviously as mayor she had a good health benefits package in spite of the lousy pay, and was not doing any worse working for Daley, and of course in the Congressman's office she had one of those great Federal Employees Health Benefits Program plans that made Senators Grassley and Vitter so mad... Oh. Wait.

It just occurs to me that when she says she "had to buy an individual policy on the open market" she is not telling the truth. At all. As a Federal employee who lost her job through no reason of her own, when Foster lost in the 2010 shellacking, she was entitled to keep the FEHB policy she had  under a COBRA-like policy for federal workers for 18 months, or she could convert it to a local Blue Cross/Blue Shield plan back home in Illinois with no time limit. That's how she got such a terrific price, perhaps, for her two or three years of service to our Legislature: because congressional staff FEHB policies are not age-rated on an individual basis. She's been paying the premium of a 30-year-old!

But no good grift lasts forever, and her premium would have gone up significantly anyway if BC/BS in Illinois hadn't just decided that they can't raise premiums on this product as much as they want to under the terms of the Affordable Care Act. Sue Klinkhamer clearly saw it coming, too, more than a year ago: that's why she decided go back into politics, running in the Democratic primary to select a candidate for Kane County Board chairman and see if she could suck up some more of that largesse.  But she lost, so now she's out there just looking for some attention. And she is going to get it, too. Hope some of it is the kind of attention she deserves.
In debate, October 2012. Via Courier News of Chicago suburbs.

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