It seems as if, for every 50,000 people who sign up for Medicaid or a private health insurance plan under Obamacare, there's a new rate shock story. This week there have been two big ones — a Washington state freelancer who will pay 94 percent more for his insurance, and an Obamacare success story that turned out to be unsuccessful. These aren't easily debunked stories of people who haven't bothered to factor in their subsidies either. There are about 5 million Americans who will be negatively affected by the "Affordable" Care Act with higher premiums, and they have been more visible than the tens of millions of uninsured people who will sign up on the exchanges (assuming they work) or enroll in Medicaid. Here's why we tend to hear more from middle class rate shock victims.
Their stories reveal holes in the law
No law's implementation is perfect, but some rate shock stories delve into the flaws and undefined areas of the law. Obama supporter Bruce Barcott wrote on Monday about losing his old plan in The New York Observer. His family's premium rose 94 percent, and because he and his wife are freelancers, he's not sure what his income will be next year. He wrote:
If you want to get an idea of our monthly and yearly incomes, imagine a sine wave drawn by a drunken sailor. Last year my wife and I, we made out all right. This year’s kinda lean. Which year did the exchange want? Unclear.
Barcott brought up a good point. "Hadn't thought about freelancers income vis a vis subsidies before this," wrote BuzzFeed's Kate Nocera. And as The New York Times' Ross Douthat pointed out, Barcott also has access to a pretty big platform. "Obamacare's disproportionate impact on successful freelancers is a small but notable factor in the WH's PR mess," he tweeted.
They're useful political tools
Barcott raises a good point, especially if you're an Obamacare detractor. It's easy to ignore the part when he says, "We’re willing to suck it up and pay our fair share for health insurance. We want the exchanges to work," and focus on the fact that he's a liberal facing a 94 percent premium spike.
"Disillusioned Obama supporter has his health policy cancelled. $3600 higher premium," wrote Byron York, the Washington Examiner's politics writer and author of The Vast Left Wing Conspiracy. "But free glasses for his son!" Or, as the person behind RedGalBlueState tweeted: "Another Obama acolyte gets hit upside the head by math and reality." Barcott would argue that he's not "disillusioned" so much as critical of the way the law has been implemented, but that doesn't sound as good.
Bad news is more interesting, and sometimes more informative
No one wants to hear about a law doing something it's supposed to do — in this case, insuring people. But if those stories turn out to be false, that's another thing entirely. Jessica Sanford, the Washington state single mother whose insurance story President Obama read during last month's Rose Garden speech, isn't getting insurance after all. She, along with 8,000 other Washingtonians, received incorrect subsidy estimates from the state's exchange. Her premium went from $169 a month to $280 a month for a Gold plan. Then, because the state still didn't have the right number, it shot up to $390 for a Silver plan. “I had a good cry,” Sanford told CNN. “This is it. I’m not getting insurance. That’s where it stands right now unless they fix it.”
BuzzFeed, CNN, and the conservative blogosphere all picked up the story. Fox News' Greta Van Susteren tweeted:
VIDEO: The Story of Jessica Sanford and Her Very Rude Awakening on ObamaCare http://t.co/eJ1YaBKC0s— Greta Van Susteren (@gretawire) November 19, 2013
While RedState's Moe Lane recommended pity (emphasis Lane's):
I know that it’s hard to be sympathetic, sometimes. But this is a thing that is happening to people all over the country, and all the smug little proclamations and excuses by President Barack Obama and Governor Jay Inslee and the rest of the Democratic party leadership are doing nothing to help Jessica Sanford, and people like her, and people like her kid. It is our obligation as good and decent people and as patriotic Americans to figure out a way to stop Obamacare before it hurts more people like Ms. Sanford. It just simply is.
The story is embarrassing for the president, ironic, and lends itself to clever headlines. But it also draws attention to the fact that 8,000 people in Washington state should be worried about their subsidy calculation, as should the rest of the country. The kinks Obamacare has to work out during its first year could have major and minor consequences.
There's a bias towards the middle class
Stories of low-income and working-class people receiving quotes for obscenely expensive premiums are usually easily debunked. It's the members of the middle class who don't receive employer insurance who are negatively hit, and the media tends to favor that group. As Jonathan Cohn at The New Republic pointed out earlier this month:
By and large, the people receiving those cancellation notices and facing large premium increases are at least reasonably affluent. They’re not necessarily rich, particularly if they live in higher cost areas of the country. ... But, by definition, they don’t qualify for huge subsidies that would offset premium increases mostly or completely. By contrast, the people getting Medicaid are poor. They have to be, because it’s the only way to sign up for the program. And as political scientists have shown, the poor don't command the same kind of attention from politicians that the middle class—and particularly the upper middle class—does.
Nine million people are expected to enroll in Medicaid by the end of next year, and several million more would join them if their state expanded the program. And while there have been stories on the coverage gap, those stories aren't as inflammatory or, more important, as specific and individualized as middle class stories of rate shock. Medicaid affects a demographic of nameless low income individuals. Rate shock affects Ashley the post-grad from Michigan, former MSNBC host Dylan Ratigan, Bruce the freelancer and Jessica the single mother.