A friend of mine has an adult child with cancer, a young man just old enough to be beyond the age of coverage under his parents’ health care plan. After nearly killing him, the dreaded Hodgkin lymphoma is in remission. But the insurance industry still can deny him a policy that might save his life.
Not for long. In six months, refusing to let sick people buy affordable health insurance — private-sector death panels, the most odious kind of American exceptionalism — will be illegal from shore to shore.
“I can’t wait for Obamacare,” my friend gushed the other day. About one in 10 people with cancer in this country have been denied health coverage.
The cartoon version of the Affordable Care Act is now moving from Beltway gasbags and caricaturists into the hands of consumers. Its fate will be determined by the countless anecdotes of people who will apply the law to their lives.
The early indications are that most Americans will be pleasantly surprised. Millions of people, comparing prices on exchanges set up by the states are likely to get far better coverage for the same — or less — money than they pay now. The law, as honest conservatives predicted, before they orphaned their own idea, is injecting competition into a market dominated by a few big names.
You won’t hear this from the entrenched forces that have spent about $400 million denouncing the law on television ads, groups like the Karl Rove-backed Crossroads GPS. They have good reason to fear it: If Obamacare works, the game will be over for those who oppose the most significant change in American life in a generation’s time. You also don’t hear much from President Barack Obama himself; once again, he’s a passive observer of his presidency.
But out among the states that are actively building the foundations of Obamacare, the law seems to be doing what it was supposed to do. In Washington state, nine companies have filed paperwork to offer policies in a region that has long been controlled by three big entities. In California, 13 companies will compete for the business of 5.3 million or so people expected to purchase insurance through the new exchanges. Officials say the average monthly premium will be $321, or $110 less than the national average predicted by the Congressional Budget Office. Florida refused to set up such an exchange, so the federal government will handle it
All of the above numbers are for individuals. For the majority of Americans, those with employer coverage, Medicare or Medicaid, little will change except that insurers can no longer put a lifetime cap on benefits. The biggest change, the one likely to drive public perception, will be felt by people long denied care because of “pre-existing conditions.” There’s a bonus opportunity for those stuck in jobs they hate, holding on only because they need the health care, for a take-this-job-and-shove-it moment.
Of course, you can expect scare stories and Fox News alerts about higher premiums. These anecdotes will focus on young, healthy people with no coverage who will have to join the rest of the country in the insurance pool, or pay a fine. Some employers will also choose to pay the government rather than insure their own workers, but you won’t find too many of those listed among the best places to work. And we’ve already seen claims of skyrocketing premiums under the new plan, but those have been widely debunked as fraudulent comparisons between bottom-of-the-bin teaser rates of today and the substantial packages of coverage required in the new law.
It’s a fascinating moment, akin to the dawn of Social Security or Medicare. Republicans actually did the country a favor by wildly overstating the case against a middle-ground approach to getting the United States closer to universal health care. As in 1935 and in 1965, the ossified right is warning once again of an impending end to American life as we know it. Thankfully, they’re right.
Timothy Egan is a columnist for The New York Times.