“I was diagnosed with lupus when I was 27. Lupus is an autoimmune disorder. It’s dramatically affected my life. I voted for Barack Obama for president. I thought that Obamacare was going to be a good thing. Instead of helping me, Obamacare has made my life almost impossible. Barack Obama told us we could keep our health insurance if we liked it. And we can’t. I got a letter in the mail saying that my health insurance was over, that it was gone. It was canceled because of Obamacare. My premiums went from $52 a month to $373 a month. I’m having to work a second job to pay for Obamacare. For somebody with lupus, that’s not an easy thing. If I can’t afford to continue to pay for Obamacare, I don’t get my medicine; I don’t get to see my doctors. I am very disappointed in Barack Obama as a president. He made promises he didn’t keep. And that’s disheartening.”
–Tennessee resident Emilie Lamb, 40, in an ad sponsored by Americans for Prosperity
I posted yesterday about the odd claims in this ad and about Glenn Kessler’s exchange with her in which she told him exactly WHY she was so happy with her old policy, which, she indicated, had a $25,000 cap on annual benefits, and no limit on out-of-pocket costs, and that it would only cover generic medications. The reason: That her hospital, Vanderbilt Medical Center in Nashville, and her Vanderbilt-affiliated specialists, were forgiving her payments, including for intravenous medications provided multiple times weekly, above $1,000 annually.
Kessler said she told him that in 2007, before she was diagnosed with lupus, she “fell off a horse, requiring seven surgeries at Vanderbilt Medical Center.” And that one surgical bill was for $125,000, but that “after negotiations with CoverTN, the hospital agreed to reduce the charges to below $25,000. In the end she barely paid anything in hospital costs after her accident.” She said, “Really after that, I was not worried about something catastrophic”–something that would exceed the $25,000 cap.
To put her [lupus] expenses in context, the American College of Rheumatology says that average cost per patient with lupus is between $14,000 and $28,000, though patients with one form of lupus have significantly higher costs – ranging from $29,000 to $63,000.
And then he provided more details from his communication with Lamb:
Once Lamb was required to go on Obamacare, she discovered she qualified for a $15-a-month subsidy, which could be applied to nearly 40 different options. She chose one of the more expensive options—a Platinum plan – because it limited out of pocket expenses to $1,500, as her doctor fees and blood tests would be higher under the Obamacare plans. She also considered a plan with a lower premium, but it would have meant higher out of pocket expenses. “Instead of paying $6,000 a year, I would have been paying $10,000 a year” with the plan with a lower premium, she said.
I titled my original post: Emilie Lamb was subsidized by her doctor’s largesse and by federal taxpayers and full-coverage-insurance policyholders. She still will be. She should acknowledge that, publicly. But today I reread Kessler’s post after I reread my own, and I realized that her claim is this: that pre-Obamacare, she had been subsidized by her doctors’ and her hospital’s largesse, but that because of Obamacare her doctors and her hospital were now requiring her to pay her full out-of-pocket costs–all her medical costs that are not covered by her new insurance plan.
The chance that this true is zero. Its sheer absurdity is why, upon first reading or hearing her complaint, it doesn’t immediately register that that is its sum and substance. She’s saying that when she had a policy that had no caps on out-of-pocket expenses, and an annual cap of $25,000 (probably well below her annual medical bills each year), her doctors and her hospital were willing to forgive all but $1,000 of those bills each year. But that now that she has a policy that has no annual cap and has a $6,000 out-of-pocket cap-–so that the hospital and doctors will receive much more of the amounts they bill than they were before–they’ve told her that she now has to pay in full that $6,000 a year. And that she chose a platinum plan rather than a lower-cost plan that has a $10,000 cap on out-of-pocket expenses because her suddenly uncooperative hospital and doctors would require her to pay the full $10,000 in annual out-of-pocket expenses rather than just the full $6,000 in full annual out-of-pocket expenses for the platinum plan. Because of Obamacare.
No matter that Obamacare has a maximum annual out-of-pocket cap of about $6,500.
Because of Obamacare, her hospital and doctors said they would require full out-of-pocket payments from her rather than forgive the now-much-smaller amounts above $1,000 a year that her insurance plan will cover. So because of Obamacare she chose a platinum plan rather than a gold or bronze one that was the same cost as her cancelled one. No, she didn’t chose the platinum plan out of fear that her old tin plan would leave her bankrupt or unable to access the care she needs if her hospital and doctors suddenly withdrew their largesse. Uh-uh. Because of Obamacare she suddenly needed a platinum plan. So she bought one. Even though paying for it makes her life almost impossible.
Reader Urban Legend posted this comment to my earlier post:
Besides the fact that her policy was crap, it appears there are numerous bronze or silver plans available in Tennessee to a 40-year-old for between $150 and a little over $200 (in Davidson County, Nashville, presumably the most expensive county in the state) . That is the overwhelming majority of plans, and that is without any tax credit assistance. Plans near $373 for someone that age are gold or platinum plans, some with $0 deductibles and out-of-pocket maxes at $1500 or less.
And presumably her employer is continuing to contribute the same amount as before. She was happy with her old plan, but would not have been happy with one for about the same cost as that old plan and that has better benefits, so that more of her medical bills will be paid by her insurer. Her hospital and her doctors now want her to pay her full medical bills that are not covered by her insurance, and they didn’t before Obamacare.
Her hospital and doctors must be Republicans. She shouldn’t have told them she voted for Obama, thinking that the ACA would help her. They sure showed her!
And to think she had thought Obamacare would help her–by requiring her hospital and her doctors to provide free lifetime healthcare for her, saving her $1,000 a year.
Lamb, it turns out, was, like Julie Boonstra, a guest of her Tea Party Republican congressional representative at the State of the Union address. And, like Boonstra, she’s a pretty cheap date.
UPDATE: Here’s an exchange between reader EMichael and me this morning, 3/2, in the Comments to this post:
I wonder what the financial effects on the hospital and doctors who are forgiving her debts?
And who pays for that forgiveness?
Another thought, I wonder if Ms Lamb has already been hit by the IRS for this past debt forgiveness, or will be hit now that she has gone public?
Hi, EMichael. My earlier post on her did make the point that it’s the federal government (in very substantial financial assistance to hospitals for the very purpose of helping them cover the uninsured or the underinsured–an important purpose of the ACA), and her doctors, and people who do have comprehensive insurance, that have been footing her very large medical expenses. In this current follow-up post, I make the point–which I originally missed and which Kessler missed–that she makes, in essence, a key claim to Kessler that surely is false: that her hospital and her doctors have told her they will no longer forgive her uninsured bills that total more than $1,000 a year, and that their reason is Obamacare.
And if THAT is false, and her hospital and her doctors have told her no such thing, then she was flagrantly lying by saying that she was happy with her old plan. If she was happy with her old plan, which had NO cap on out-of-pocket expenses and a total annual cap of $25,000, because she felt she could continue to rely on the generosity of her hospital and doctors to forgive all but $1,000 a year, why would she have been unhappy with a bronze or gold plan that would have paid her hospital and doctors more than her old plan did? Why did she believe that she now would have to pay out-of-pocket expenses of $10,000 annually under a plan that would have cost her and her employer–who presumably is still contributing the same amount as last year–the same as her cancelled plan did last year, and instead chose a platinum plan whose premiums are causing her to take a second job and making her life almost impossible in order to have to pay $6,000 a year rather than $10,000 a year in out-of-pocket expenses? Why is she suddenly no longer comfortable relying on the special $1,000 annual cap that her hospital and doctors were providing her, and why is she claiming that Obamacare is at fault?
I’m going to email Kessler and ask that he inquire further about this. If Lamb refuses to answer, maybe he can ask the Vanderbilt Medical Center whether they’re now refusing to forgive out-of-pocket expenses because of Obamacare, and, if so, what it is in the ACA that has caused them to make that decision. If Kessler won’t do it, I’ll ask PolitiFact or even Greg Sargent to do it.
This is serious stuff. This woman has so little concern for others who have serious chronic illnesses that she’s willing to baldly lie in exchange for a free trip to Washington. Wow. I mean, really. Wow.
I’ll add that I’m pretty sure that the IRS does not consider a hospital’s or doctor’s forgiving of medical costs to a patient who cannot pay those costs taxable income. I certainly hope it doesn’t. It’s basicly a gift of medical services. But Ms. Lamb pretty much personifies the ultimate in chutzpah by claiming falsely that Obamacare has, rather than helped her, instead made her life almost impossible by causing her hospital and doctors to stop forgiving her uninsured medical bills of more than $1,000 a year because under Obamacare those uninsured medical bills will be much lower and because she chose to pay more in order to reduce those uninsured medical bills to $6,000 a year rather than to $10,000 a year–now that, thanks to Obamacare, she has access to private healthcare plans.
Several commentators have noted that the AFP ads curiously stage only middle-aged women who have chronic life-threatening illnesses, and who make “reasonable judgments” that they were harmed, based upon flatly false beliefs or representations.
So here’s what I suggest to the Democrats: Have a middle-aged woman who has a chronic life-threatening illness ask in an ad why the AFP keeps portraying middle-aged women who have chronic life-threatening illnesses as deeply ignorant, seriously math- or logic-challenged, or just plain easily manipulated. In fact, of course, these women are knowingly propagating a fraud about what they, of all people, know is, for many, many others a life-or-death, or bankruptcy matter.
They’re con artists, pure and simple.