Edie Littlefield Sundby may not have thought she’d ignite a national debate when the stage-4 cancer survivor asked us to publish her Monday op-ed on losing her oncologist due to the Affordable Care Act. But she certainly has, and it’s important to understand why. Mrs. Sundby and millions like her must be denied their medical choices if ObamaCare is going to work as its liberal planners intend.
Mrs. Sundby’s seven years of gallbladder cancer treatment have been underwritten by a policy known as preferred provider organization coverage, or a PPO, from UnitedHealthcare. She says she bought the product on the individual insurance market for herself and her family in large part because it offers more choice in medical care. PPOs cost more than health-maintenance organizations (HMOs), for example, but they offer access to more doctors and hospitals.
This proved invaluable for Mrs. Sundby, who needed expert care from various providers after her diagnosis. Under her PPO, the San Diego resident could go to a local hospital for some treatments, but her main oncologist is at Stanford, and she could also seek counsel at M.D. Anderson, the renowned cancer center in Houston. The choices she has under her PPO have literally extended her life for seven years.
But in July UnitedHealthcare announced that it is withdrawing from the California individual market, and Mrs. Sundby’s policy will be cancelled on December 31. A UnitedHealth spokeswoman explained the decision to us this way: “Because of UnitedHealthcare of California’s historically small presence in the individual market and the fact that individual consumers in the state are well served with many competitive product offerings, we will focus on our employer group insurance and Medicare business in California for 2014.”
The company covered only 8,000 or so customers in California, where the individual market is dominated by Kaiser, Anthem Blue Cross and Blue Shield of California. Another competitor, Aetna, is also fleeing California, leaving about 50,000 policyholders in the lurch.
Dan Pfeiffer, President Obama’s chief political spinner, sent out a now infamous tweet on Monday linking to a left-wing website that blamed Mrs. Sundby’s policy loss on UnitedHealthcare. The White House default is always to blame the insurers. But UnitedHealthcare only fled the state because ObamaCare’s subsidized exchanges are meant to steal their customers. As more people are pulled into government coverage, policies like Mrs. Sundby’s are harder to sustain economically, so insurers bail.
The reason goes to the political control that is the animating purpose of ObamaCare. No fewer than 33 insurers tried to join the California exchange, but state regulators would only approve 13. This is by design because ObamaCare’s planners want to limit insurance choices to reduce costs and to equalize coverage. Having opted out on first call, UnitedHealthcare is now barred by a California “lock out” clause from selling individual insurance until 2017.
President Obama praised this California exchange model in June for its “excellent results,” adding on a trip to San Jose that “none of this is a surprise. This is the way that the law was designed to work.” Precisely.
To stem the uproar over cancelled insurance, Mr. Obama and the left are now insisting that the old policies were inferior and the new exchange policies are better. But tell that to Mrs. Sundby and millions of others who are willing to pay to have access to the hospital and doctor of their choice.
The truth is that ObamaCare’s insurance is by and large the inferior coverage, which is why insurers are calling it “Medicaid Plus.” To keep costs low, ObamaCare has to stuff patients into policies with narrow doctor networks and fewer treatment choices. Liberals then fall back on the claim that everyone’s coverage is guaranteed—unless, of course, you live in San Diego and want to get care at M.D. Anderson.
As it imposes these policy cancellations, ObamaCare is also systematically destroying one of the best features of the current individual market, known as “guaranteed renewability at class-average rates.” This meant that once an insurance policy was issued, people could renew their coverage year after year at the same rates as their peer group. So someone like Mrs. Sundby who got sick would not pay higher premiums than average and her insurer could not deny coverage—unless UnitedHealthcare quit the business. This guaranteed renewability is no longer a guarantee thanks to ObamaCare.
Mrs. Sundby’s crisis is one story among millions, but it illustrates Nietzsche’s aphorism that convictions are more dangerous than lies. Critics are rightly noting that Mr. Obama sold reform with the falsehood that Americans could keep their policies if they liked them. But the scary part is that Mr. Obama and his health planners truly believe that everyone should receive the same medical care and pay for it the same way.
The reason Edie Sundby had to lose her plan is because her needs, and her measure of her own well-being, are different from Mr. Obama’s, and that is now unacceptable.