No law has done more to reform health insurance and protect consumers against the industry's most heinous practices than the Affordable Care Act. But Obamacare didn't magically transform insurers into benevolent entities solely devoted to taking care of sick people.
Health insurance companies, even those that are not-for-profit, have to collect more money in premiums than they shell out in claims for medical care. That means they have a financial incentive not to pay for things.
And since health insurance companies can no longer shun the sick to maximize profits -- either by denying coverage to people based on their medical histories or by rescinding the policies of paying customers who fall ill and rack up bills -- insurers are employing other tactics to shift costs to sick people and make it harder to get health care, consumer advocates say.
"Coverage denied...doesn't meet criteria for medical necessity". I WOULD CALL SAVING MY HUSBAND'S LIFE A MEDICAL NECESSITY YOU F_____S
— Zoe Keating (@zoecello) May 28, 2014
Insurance companies can no longer deny coverage based on preexisting conditions. But they have dreamed up ways to comply with the letter of the law while ignoring the spirit.
By structuring their health plans a certain way, patient advocates say insurers are discriminating against some patients by forcing them to pay the highest tier drug costs for certain prescriptions—or by discouraging them from signing up from the plans, leaving insurers with only healthy patients.
In Florida, for example, four insurers – Cigna, CoventryOne, Humana and Preferred Medical – have been accused of discriminating against people with HIV/AIDS. A recent complaint filed with the Health and Human Services Department alleges that the insurers placed all covered HIV/AIDS prescriptions in the highest drug tiers requiring patients to pay significant out of pocket costs---sometimes an upwards of $1,000 each month.The truth is that there is nothing extreme about the ACA. It's just some common sense reforms that perhaps don't go far enough. By painting it as something radical, conservatives are ignoring objective reality and simply making themselves look foolish.
This case brings to mind the axiom 'be careful what you wish for.' Republicans were right, strategically at least, to try to stop the ACA from taking effect before millions of Americans were receiving coverage from it. If they by chance succeed in dismantling and unraveling coverage for millions now receiving subsidies they will be the dog that caught the car.