Boehner's list of Obamacare tragedies

John Boehner's long J'Accuse list of the President's Obamacare crimes cites a total of eleven bullet points: a bunch of harrumphing about IF YOU LIKE IT YOU CAN KEEP IT!!! and three specific cases : a woman who's pissed off at how little the exchange does for her when the rules are specifically designed to keep her from using the exchange, which she does not need; a woman who's pissed off at having to be covered for maternity benefits when she's already got four kids, who has not even bothered to find out how much she'll be paying; and a large metropolitan area that isn't pissed off at all, though for some reason Boehner is.

• WATCH: “A woman in North Carolina has seen her insurance plan canceled and her premium’s increasing by over 50% due to Obamacare’s regulations, WRAL-NC reports.” (Free Beacon)

The woman in North Carolina is Ruth Ann Grimes, music director at a United Methodist Church in a Raleigh suburb, who wrote to the News Observer August 29:

I must take issue with your Aug. 27 editorial “Might Obamacare work?” You are so far to the left, you are going to fall off the side.

I recently contacted my health insurance company to see how the Affordable Care Act would affect me. Although the actual rates will not be available until mid-September, I was told my monthly premiums will “increase substantially” due in part to the many new taxes and fees associated with the ACA, my deductible will be higher and I do not qualify for subsidies or tax credits. So, how is this affordable for me?

Whoa. If that's how she felt about it before she had any idea how the law would affect her, how does she feel now? Yesterday, when she seems to have gotten a little more information, she provided some of it to WRAL TV:

For the past three years, Ruth Ann Grimes had a health insurance plan that she says served her well for a $381 monthly premium.

But Blue Cross Blue Shield of North Carolina recently told her that the plan doesn't meet the minimum requirements of the Affordable Care Act. Instead, Grimes could choose a plan with a $562 monthly premium.

"It's been aggravating to see a policy you were perfectly happy with doesn't exist anymore, and you can't keep it. You have to go on another plan," she said.

The 55-year-old Johnston County resident said she could shop the marketplace, but as the wife of a North Carolina State University professor, she said she wouldn't qualify for any government subsidies to help pay the premium.

"The Affordable Care Act did not make it very affordable for me," she said. "It's not that I don't want anyone to have health insurance or health care because that's not the case. It's just trying to make it affordable for everybody."

Grimes said she plans to go back on her husband's State Health Plan coverage. It's more expensive than her existing plan but will cost less than the Blue Cross alternative.

Well, duh. You don't get the benefits of a subsidized Marketplace plan if your spouse has an employer plan—why should the government subsidize you when NCSU has been ready to subsidize you for the past 20 years and you've turned them down? (That's why she will now be going "back" to it, she was on it before.) The Act is for people who couldn't get affordable care before, not for people who had access to it but went looking for a still cheaper bargain. As with Sunday's  Betsy Tadder,  that Blue Cross alternative is not even legally available to her.

At least she's dropped the imaginary "many new taxes and fees" and "higher deductible" (as ever, it's because her current deductible is excessively high that BC/BS is forced to improve or drop the policy). But it's lovely how she insists that even though everything she said about it in August was false she's still determined to hate it. Wait till she finds out couldn't have it anyway.

Boehner, meanwhile, is flat-out falsifying when he claims her premium is "increasing"; rather, you could say she's being trapped into having an actual insurance policy instead of giving her money to Blue Cross in return for nothing.

The husband teaches poultry science, by the way, specializing in turkey.

• “Cohen was one of the millions of Americans... who are receiving letters from their insurance providers announcing that their plans will be canceled in 2014 as a result of federal health care reform. ... ‘I was perfectly happy with the plan I had. It covered everything I need. It covered my preventative care and all the tests I needed,’ she said.” (Bucyrus Telegraph Forum) 

That's Amie Cohen, of Lancaster, Ohio, who believes her plan was canceled because

it doesn’t offer something the 52-year-old mother of four said she doesn’t need: maternity coverage, which is considered an “essential benefit” that all plans must provide under the federal health insurance overhaul.

In fact at the time of the interview (November 6, people) she had no idea whether the new plan was going to raise her premium or not:

it’s unclear what the direct cost will be for Cohen, whose family’s insurance cost may go up depending on whether or not they qualify for tax credits eligible to households up to 400 percent of the poverty level.

Why the Bucyrus Telegraph Forum decided to print her story anyway, in spite of its not having an ending, or decided not to, or not to ask her to, look it up, whether on healthcare.gov or one of the online subsidy calculators, I do not know. They do give a fairly good account of how these plans without maternity benefits got "grandfathered" in the Bill (YOU CAN KEEP IT) but are being canceled by insurance companies anyway, because they can't significantly change them in any way (like cutting benefits or raising copays or coinsurance or deductibles) and can't sell new ones.

It may also be worth noting that it's not "maternity benefits" but Ten Essential Benefits singled out as required under the law:

Ambulatory patient services

Emergency services

Hospitalization

Maternity and newborn care

Mental health and substance use disorder services, including behavioral health treatment

Prescription drugs

Rehabilitative and habilitative services and devices

Laboratory services

Preventive and wellness services and chronic disease management

Pediatric services, including oral and vision care

Being capable of childbirth is a preexisting condition, for which women younger than Ms. Cohen are no longer being punished, any more than people with lupus or schizophrenia. We're all paying for it. That's how insurance works. Ms. Cohen already had hers, and somebody else shared in paying for all four of them; now it's her turn to share.

• “…the Affordable Care Act will cost the city of Albuquerque an additional $875,000 in the current fiscal year and Bernalillo County an additional $349,000…” (Albuquerque Journal)

This one seems to be quite true! Local and county governments and 17 agencies have come together to form an insurance purchasing pool for their 22,700 employees, and the law lays down certain requirements: $5.25 per month per employee to fund a high-risk pool, through 2016 (it is thought that medical expenses will be on the high side for the first couple of years, as people take care of problems that they have previously let go because they couldn't afford to deal with them); 16 cents per month per employee for research into treatments, through 2019; and 1.6 percent of the premium, forever, to subsidize people at less than 400% of the poverty line.

The city of Albuquerque currently spends $4,403,535 a month on health insurance for employees and their dependents. The cost will rise to $4,549,373 a month when the fees take effect, an increase of 3.3 percent.

For the first three years of the program and approaching nothing thereafter. It's not very much money. And it does a lot for its bucks. That's all you got, Boehner? Puh-lease.

All photos by Debbie Roos for Growing Small Farms, from North Carolina State University as it happens (Jesse Grimes knows these heritage turkeys personally).