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Poster child comes up short

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Tuesday, Nov. 12, 2013 2:46 AM

Conservative groups are highlighting the case of Michael Cerpok, who has leukemia, whose insurance plan was canceled because it didn’t comply with the Affordable Care Act.

A news report quoted him saying he would need to pay $26,000 to keep the same doctor. It turns out, he was able to get a new plan, which has his doctor in its network, for a lower premium and a lower out-of-pocket maximum than his old plan. It’s an individual market plan, but it is not through the federal exchange.

“I didn’t want my new plan to be a part of a subsidized government-mandated health care,” he told Factcheck.

He has no problem with Americans getting subsidies to help them buy insurance, but he was opposed to the individual mandate, requiring everyone to buy coverage.

“This is about freedom to choose,” Cerpok said. He said he did not look at health plans on the federal exchange.

Estimates available on the exchange website show significantly lower rates than the $855 Cerpok had been paying. Coverage for a single person over 50 — Cerpok is 52 — starts at $237.04 per month for a bronze plan. The highest-priced plan was an estimated $576.62. The cost estimates aren’t what’s important to Cerpok.

“The health insurance industry certainly needed to be put in check, and we certainly needed to provide affordable care for low income earners,” he told Factcheck. “But, I should not have had a product that I was willing to pay for, and that I had been very happy with, taken away from me by a government mandate and then taxed…er, I mean fined…if I chose not to replace it with a product I don’t like.”

House Speaker John Boehner announced his opposition to the Employment Non-Discrimination Act (ENDA) that would prohibit workplace discrimination based on sexual orientation or gender identity with a statement from his spokesman saying the bill “will increase frivolous litigation and cost American jobs, especially small business jobs.” But the law specifically applies only to companies with 15 or more employees — which exempts nearly 90 percent of all small businesses.

Most large companies already have policies prohibiting discrimination based on sexual orientation, and a Williams Institute study found most of the top 50 Fortune 500 companies state that diversity policies are “good for their business” and “improving their bottom line.”

Neither the U.S. Chamber of Commerce nor the National Small Businesses Association is opposing ENDA. Sen. Rand Paul says the Affordable Care Act’s Medicaid expansion may “bankrupt” rural hospitals in Kentucky. But state health care leaders say its hospitals stand to benefit, since the expansion would provide insurance to those who otherwise wouldn’t be able to pay their hospital bills.

The Kentucky Cabinet for Health and Family Services issued a report that recommended expanding Medicaid in part because “our hospitals will suffer” without the expansion. The report estimates that the state’s hospitals will see a cut in Disproportionate Share Hospital (DSH) program payments of about $287.5 million over eight years, beginning in fiscal year 2014 through fiscal 2021.

It said, “States that do not implement the Medicaid expansion risk losing substantial resources that will be needed by hospitals that serve large numbers of low income, uninsured patients, without the intended reduction in the number of uninsured in the state.”

The report found that “for each dollar in private revenue that a Medicaid expansion eliminates, hospitals’ Medicaid revenue rises by $2.59.”

Its conclusion: Medicaid expansion “greatly favors hospitals.”

http://www.factcheck.org/

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