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Yep. The Koch brothers' American for Prosperity, again, with another anti-Obamacare ad. This one has actually been around for a few weeks. It features Tennessee resident Emilie Lamb, who has lupus and says "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." She's one of the many who had to change insurance plans. This ad didn't get as much attention as some of the others. Until now. This isn't one of the out-and-out lies that AFP has been pushing in its ads, but one that is still deceptive. It finds a one-in-a-million case to try to demonstrate how bad the law is for chronically ill people. So, crank up the fact-checking machine at the Washington Post.

Lamb might just be the only person with a complex, chronic illness like lupus who has her disease well under control. She says her out of pocket expenses—doctor visits and drug costs—were just $1,000 a year. She was covered by a public-private option called CoverTN, one of those state high-risk pools that offered cheap coverage for low-income workers. The plan didn't meet the new standards mandated by the law, and didn't receive a waiver from the Obama administration to continue operating this year. But it was a good deal for Lamb. For example, when she had an accident in 2007 that required several surgeries, she ended up with huge bills. One surgery alone cost $125,000. But CoverTN was able to negotiate that down to below $25,000, with the hospital eating more $100,000 in costs (and passing those costs along to all the rest of their patients). After that experience, Lamb figured she would never have to worry about "something catastrophic" bankrupting her. So Lamb was in a phenomenally fortunate situation, with a potentially devastating chronic illness that is being kept at bay, and an extremely generous hospital saving her. She's one in a million, really, a point the Post's Glenn Kessler makes.

One Lupus sufferer, Erin Kotecki Vest, blogged that she was amazed at Lamb’s tale of woe after she researched the coverage provided by CoverTN. “Just ONE of my treatments ALONE wipes out everything CoverTN had to offer me,” she wrote. “I would hit CoverTN’s $25,000 annual limit the first week of January.”

In contrast to Lamb, this Lupus sufferer is thrilled to be on Obamacare. Kotecki Vest gleefully wrote in November that her family ditched her husband’s employer-provided plan after they discovered they would save nearly $19,000 a year by switching to a plan offered on healthcare.gov.

For some reason, Kotecki Vest was not asked to appear in an AFP ad. AFP did not respond to a request for comment.

Lamb is paying a lot more: she chose a platinum plan that would keep her out of pocket costs low. So she's paying a lot more, from $52 a month to $373 a month. That makes her one of Obamacare's "losers." But she'll never have to worry again about whether she'll lose that insurance because of her lupus. Unless the AFP has its way.

Originally posted to Joan McCarter on Fri Feb 28, 2014 at 10:08 AM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (41+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Fri Feb 28, 2014 at 10:08:33 AM PST

  •  where's Frank Luntz with some new lie(frame) (7+ / 0-)

    when the GOP needs him

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Fri Feb 28, 2014 at 10:11:17 AM PST

  •  the only way this woman becomes (9+ / 0-)

    a loser is if she dies.  her new coverage is more expensive but more expansive too.  I'm sorry, but i don't believe a WORD that comes out of the mouths of these whiners.  i would be thrilled if i could get coverage for my dog, who now has an "existing condition" but insurance for animals is not required by Obamacare to cover her. At $350 a month, I would be saving about $750.  Sometimes, I just want to slap these people and yell "stfu".  I have sympathy for people with life threatening illnesses but not for those who complain when they have the coverage they would deny to others.

  •  This case illustrates a basic truth (14+ / 0-)

    when it comes to healthcare and healthcare plans. There is no perfect system or option.

    Every solution has its strengths and weaknesses and there are trade-offs and "winners" and "losers" in each type of healthcare system. Which system is "better" depends on your values and what are your priorities in what you're trying to accomplish.

    Unfortunately that is too nuanced an argument in the current political environment where somehow the market-based Republican healthcare reform from the 1990's is now "socialism" and "government takeover of healthcare".

    Blue is blue and must be that. But yellow is none the worse for it - Edith Sidebottom

    by kenwards on Fri Feb 28, 2014 at 10:58:39 AM PST

    •  Well said. And, moreover, (10+ / 0-)

      everyone (congressmen, pundits, and Koch Bro's) that vehemently attacks the ACA happens to possess Cadillac healthcare plans of their own.  So it boils down to: we have great healthcare, why should poor people have it?  As they thump their bibles without the slightest sense of irony.

    •  Exactly (4+ / 0-)
      Recommended by:
      Aquarius40, kenwards, lcbo, wilywascal

      The goal of healthcare reform can not be to improve the situation for every single person. There will always be a minority subset who managed to find a comfortable niche in the old system and who are in some disadvantaged by change. But, if the new system benefits 90 or 95 out of 100 people, then the overall effectiveness has been greatly improved. When it comes to government policies, the utilitarian rule of seeking the greatest good for the greatest number holds sway.

      This campaign shows how this increasing use of a politics of the personal (I met a woman in tennessee who told me...) completely distorts policy discussions.

    •  The woman in this ad starts her complaint (1+ / 0-)
      Recommended by:
      kenwards

      with a lie, I betcha.  I seriously doubt that any insurance company sent her a letter telling her that her plan had been canceled "because of Obamacare."  Insurance company letters cancelling plans don't usually cite a program that resulted in the plan's being canceled, but even if hers did, I have never, ever heard of an insurance company referring to the PPACA as "Obamacare."  Although I don't doubt that her plan was canceled, it's telling to me that she didn't hold the letter from the insurance company up to the camera with the words "because of Obamacare" circled in red.  

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Fri Feb 28, 2014 at 01:34:45 PM PST

      [ Parent ]

      •  The Tennessee Websites (0+ / 0-)

        for CoverTN and CoverKids did/do in fact blame the ACA for loss of coverage (not "Obamacare," but the actual title of the law). She would have received a letter from the state, not her insurer, and I'm willing to be it blamed the act as well.

        CoverTN

        Never interrupt your enemy when he is making a mistake.

        by Libertina on Fri Feb 28, 2014 at 01:56:07 PM PST

        [ Parent ]

    •  Another basic truth (0+ / 0-)

      Every piece of legislation passed by Congress or the States, and especially big, complicated bills like the Affordable Care Act, require some remedial tweaking and amending due to unintended consequences. Even the simplest, most straightforward laws can suddenly pop up with basic unfairnesses that the lawmakers never intended. Sometimes these can be remedied through the administrative rules or other supplemental procedures implemented by the agency administering the law. Other times, the law has to be amended to deal with situations that weren't foreseen at the time the law was put together.

      So the question is, understanding this basic principle of law-making and the complex nature of the Affordable Care Act, what has Congress been doing in the last four years to address these difficulties? We know the House Republicans have tried to "repeal" the Act 40 times or more, knowing it wasn't going anywhere in the Senate and surely wasn't going to be signed by President Obama.

      Will anyone in the popular media dare ask one of these poor victims why they haven't contacted their Representative to find out what the House intends to do to fix the law so that they aren't victimized anymore?

      •  Unforeseen consequences indeed (0+ / 0-)

        "Even the simplest, most straightforward laws can suddenly pop up with basic unfairnesses that the lawmakers never intended. Sometimes these can be remedied through the administrative rules or other supplemental procedures implemented by the agency administering the law. Other times, the law has to be amended to deal with situations that weren't foreseen at the time the law was put together."

        Sorry for the long quote, but this highlights the issues that have and will pop up with the Constitution, which the authors made amendable for just that reason. Did they really intend for citizen militia members to have cannon in their possession?  Such as the .50 caliber sniping rifles.

        Or protect absolute right to use property in ways detrimental to the general welfare? Building on offshore islands and screwing with the coastal protection?

  •  Please help me here (0+ / 0-)

    Okay Koch Bros.  Okay ACA.  

    So she's "lying" just a little bit?

    Harry overreached, perhaps a little bit?

    Which the f' is it?

    It is a blessing?  It is a curse?  It all depends?

    With all due respect, your spinning considerably over the past few days, imho.

    "When you're wounded and left on Afghanistan's plains, And the women come out to cut up what remains, Jest roll to your rifle and blow out your brains An' go to your Gawd like a soldier." Rudyard Kipling

    by EdMass on Fri Feb 28, 2014 at 11:39:14 AM PST

  •  Unreal... (1+ / 0-)
    Recommended by:
    MyMy

    Literally every one of the crooks and liars examples have been shown to be easily verified BULLSHIT.

    Is 60 Minutes going to expose it? Meet the press? Fuck no.

    It's all rigged. And to add insult to energy, the GOP will likely gain seats in congress.

    We're fucked.

    What is so unnerving about the candidacy of Sarah Palin is the degree to which she represents—and her supporters celebrate—the joyful marriage of confidence and ignorance. SAM HARRIS

    by Cpqemp on Fri Feb 28, 2014 at 11:41:04 AM PST

  •  A white woman from Tennessee (7+ / 0-)

    who voted for Obama?  I call bullshit.

    29, white male, TX-07 (current), TN-09 (born), TN-08 (where parents live now)

    by TDDVandy on Fri Feb 28, 2014 at 11:41:39 AM PST

    •  I'm white and voted for Obama 2x (3+ / 0-)
      Recommended by:
      JJ In Illinois, TDDVandy, hbk

      What is your point?  She's a woman?  She lives in Ten?  She's not happy?  What?

      "When you're wounded and left on Afghanistan's plains, And the women come out to cut up what remains, Jest roll to your rifle and blow out your brains An' go to your Gawd like a soldier." Rudyard Kipling

      by EdMass on Fri Feb 28, 2014 at 11:46:26 AM PST

      [ Parent ]

      •  Heh. (2+ / 0-)
        Recommended by:
        JayBat, wilywascal

        I'm making a crack.  My mother is a white woman from Tennessee who voted for Obama twice.  But they are few and far between.

        And, I sort of doubt any white woman from Tennessee who actually voted for Obama would be in any way willing to appear in a Koch Bros. ad, but what do I know?

        29, white male, TX-07 (current), TN-09 (born), TN-08 (where parents live now)

        by TDDVandy on Fri Feb 28, 2014 at 01:14:15 PM PST

        [ Parent ]

  •  Can these ads be thwarted? (4+ / 0-)
    Recommended by:
    La Gitane, Sherri in TX, GussieFN, MyMy

    A few rebuttal ads showing that some of these anti-Obamacare ads are bunk should help throttle down some of the lies and deception coming from the right, you would think.

    I wonder if these are planned.  Maybe this will come closer to election time.  

    •  This isn't bunk, though. (4+ / 0-)
      Recommended by:
      saucer1234, 88kathy, ngh, hbk

      It's a one-in-a-million case, but she's still getting screwed.

      Instead of rebutting these ads--even the ones that are egregious lies--my ponydream is that we say, "And that is why we on the left truly want Medicare for All!"

      "Gussie, a glutton for punishment, stared at himself in the mirror."

      by GussieFN on Fri Feb 28, 2014 at 11:53:59 AM PST

      [ Parent ]

      •  I disagree (4+ / 0-)
        Recommended by:
        GussieFN, Aquarius40, JayBat, sharman

        she is not getting screwed. She is paying a small amount (I consider $350 a month small) for unlimited coverage. Wheo was getting screwed were the taxpayers that subsidized her health insurance, pre-Obamacare.

        •  She's a moocher! (0+ / 0-)

          She's paying $300/month more, because of Obamacare. I don't know her financial situation, but that's certainly not a 'small' amount for many people.

          There will be losers with Obamacare. We knew that all along. We can move into a defensive crouch and pretend that the Republican-inspired Obamacare is near-perfect, instead of merely being a tremendous improvement, or we can use these stories as a way to declare what we really believe.

          "Gussie, a glutton for punishment, stared at himself in the mirror."

          by GussieFN on Fri Feb 28, 2014 at 12:10:11 PM PST

          [ Parent ]

      •  How is she being 'screwed'? (0+ / 0-)

        Her premiums are up. But no hospital will have to 'eat' at taxpayers' expense her costs when she cannot cover them.

        My question is why her public/private Tennessee plan didn't meet the ACA requirements, even for the waiver? There must be something about it that doesn't smell right, no?

        Lots of peoples' premiums go up every year.  

        •  CoverTN (1+ / 0-)
          Recommended by:
          sharman

          did not meet the ACA rules and was discontinued as of Dec. 31, 2013. The state cancelled the program, not the insurance company, so the waiver wouldn't have matters. Tennessee is a red state and the legislature wants the ACA to fail, so they left a lot of people out in the cold.

          Never interrupt your enemy when he is making a mistake.

          by Libertina on Fri Feb 28, 2014 at 01:58:04 PM PST

          [ Parent ]

      •  She's not getting screwed. (5+ / 0-)
        Recommended by:
        GussieFN, JD SoOR, lcbo, sharman, wilywascal

        On her old plan, she was throwing the dice every single day; she was one car accident or one lupus flareup away from bankruptcy, every single day.

        In fact, SHE LOST THAT DICE THROW once, falling off a horse and blowing far past her plan's limits. Normally, in that case, the hospital unleashes collection agencies and hounds the victim into bankruptcy. Instead, for whatever reason, the hospital waived almost all the debt.

        Ms. Lamb appears to have learned the same lesson from that incident that a 14-year-old boy would learn: "Woo-hoo, I'm invincible now!".

        This is a non-story.

        -Jay-
        

  •  She now pays only $373/month? (7+ / 0-)

    Here's a woman who was getting away with paying only $52 a month for health coverage and now has a platinum plan that only costs her $373.  Sounds to me that she was one of those "takers" the GOP has been bitching about!

    •  That was my reaction too (1+ / 0-)
      Recommended by:
      Aquarius40

      I have an employer-provided plan that costs me that much for a 70-30 traditional.  Of course that covers me and my youngest (who's still under 26) and there ARE better coverage plans... with predictably higher costs.  But to get what she's getting -- with a chronic pre-existing illness for $373?

      I'll believe corporations are people when one comes home from Afghanistan in a body bag.

      by mojo11 on Fri Feb 28, 2014 at 12:03:17 PM PST

      [ Parent ]

    •  The TN taxpayers and other patients at the (1+ / 0-)
      Recommended by:
      sharman

      hospital that had to eat her $100,000 bill agree with you JimE.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Fri Feb 28, 2014 at 01:40:57 PM PST

      [ Parent ]

      •  In a certain sense, healthy people always eat sick (0+ / 0-)

        people's $100,000 medical bills. That's how health insurance is supposed to work.

        For example, I have a friend whose recent symptoms suggest she may be developing lupus (I hope not). She is far from wealthy. If she does indeed develop it, then the rest of us healthy people will be paying for the bulk of her treatment, no matter where she is treated. That said, I believe her financial and medical situation would be nearly untenable in the absence of Obamacare (in the event it is lupus that she has).

        As a usually very healthy person with a usually very healthy family, I'm always glad to eat my share. Yum!

  •  With that platinum plan (9+ / 0-)

    her OOP costs should be next to nothing. And I'm sorry, but the simple fact that she chose the platinum over the bronze shows that she is definitely concerned about her OOP and is willing to pay extra - a lot extra - to avoid it.

    If her lupus is as manageable as she claims, then why not pick a bronze plan, that probably wouldn't cost much more than her crappy $50 plan? She's asking us to believe that her old plan was as good as a platinum plan?? With all her health problems?

    I've got a bridge in New Jersey to sell you...

    Money should be treated like any other controlled substance; if you can't use it responsibly then you don't get to use it.

    by La Gitane on Fri Feb 28, 2014 at 11:54:56 AM PST

    •  Am I reading this wrong? Her out of pocket with (5+ / 0-)
      Recommended by:
      GussieFN, La Gitane, Noamjunior, myboo, lcbo

      the $52 plan could be $25,000

      but her lupus was under control and only cost

      $1000 a year.

      I am lost on the emergency surgeries.

      Need total amount for surgeries and how much she had to pay. I assume she had several and paid $25,000 medical expenses the whole year.

      But now she pays. $4,476 per year and will never pay much of a deductible at all.

      So her surgery year + maintained lupus = 5.6 years of premiums on her 'horrible plan'. I am thinking she has switched to a better pony for this race.

      Is that right? I am horrible at math.

      Now they have the 2nd (safety net for sloppy) Amendment, and can't be infringed to actually treat their gun like a gun and not a video game controller.

      by 88kathy on Fri Feb 28, 2014 at 12:09:30 PM PST

      [ Parent ]

      •  Nope you're right (3+ / 0-)
        Recommended by:
        88kathy, lcbo, sharman

        I commented below that the math doesn't add up. Her surgeries would have DEFINITELY maxed her out, so how on earth would her lupus been covered those years? Or how many years has she been diagnosed?

        Bullshit all around...

        Money should be treated like any other controlled substance; if you can't use it responsibly then you don't get to use it.

        by La Gitane on Fri Feb 28, 2014 at 12:14:31 PM PST

        [ Parent ]

      •  No, no, no. The TOTAL COVERAGE LIMIT (0+ / 0-)

        under her old plan was $25K per year. A semi-private hospital room is around $1800/day; no doctor, no surgery, no meds, just a bed in a hospital room.

        It sounds like her OOP was near zero (until you hit the limit, then it was 100% OOP).

        -Jay-
        
        •  So you are saying that for $52 a month or $624 (1+ / 0-)
          Recommended by:
          lcbo

          a year she got $25,000 a year to spend on medical - no deductible.

          That sounds backwards to every catastrophic insurance policy I have ever heard of. The insurance company would quickly go out of business if they charged $624 a year and gave out $25,000 a year for medical expenses. These people in the CoverTN were all high risk. Right?

          I think you have it backwards.

          Now they have the 2nd (safety net for sloppy) Amendment, and can't be infringed to actually treat their gun like a gun and not a video game controller.

          by 88kathy on Fri Feb 28, 2014 at 02:18:27 PM PST

          [ Parent ]

          •  From the WP (0+ / 0-)

            Factchecker blog:

            The Facts

            Lambu2019s old plan was provided through a public-private program aimed at lower-income workers called CoverTN, which split the premium costs between an employee, the employer and the state. Thatu2019s a big reason why Lambu2019s premium was only $52 a month, but in an interview she said she would have gladly paid and could have afforded the full $156 a month.

            Why was the plan so inexpensive? For one thing, it had a $25,000 cap on annual benefits. It also had no limit on out-of-pocket costs, and it would only cover generic medications.

  •  One quibble.. (2+ / 0-)
    Recommended by:
    88kathy, TKO333

    and, this has nothing to do with this specific story..

    But it was a good deal for Lamb. For example, when she had an accident in 2007 that required several surgeries, she ended up with huge bills. One surgery alone cost $125,000. But CoverTN was able to negotiate that down to below $25,000, with the hospital eating more $100,000 in costs (and passing those costs along to all the rest of their patients).
    This is very much in line with the level of discounts given to major insurers.  I recently had some medical supplies for which the medical supply company charged my Blue Cross plan over $700.  BC/BS paid $115.

    The hospital is eating nothing.   And there is no "loss" to pass on to its other patients. The real cost for those services was probably just about what CoverTN paid.

    The sad part about health care in this country is that the only ones ever charged the "full price" - i.e the inflated astronomical prices - are the people who have no insurance.

    All the sob stories from hospital associations that claim they are losing billions of dollars is really just bullshit.  Their real costs are only about 10-20% of what they claim.

    •  Let's ask the administrators of all the (1+ / 0-)
      Recommended by:
      sharman

      rural hospitals that are closing across the country - at least in those states that didn't expand their Medicaid program.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Fri Feb 28, 2014 at 01:48:01 PM PST

      [ Parent ]

  •  I bet (0+ / 0-)

    she doesn't even have lupus.

  •  We are beginning to see the same pattern (3+ / 0-)
    Recommended by:
    Sherri in TX, Aquarius40, PinHole

    of deception on this issue, in state after state.

    Thank you, Joan, for your diligent follow-up on this issue.  The sort of thing reporters are supposed to do.  Duh?  Kudos to so many of our state bloggers who are doing likewise.

    Not only that the stories either don't add up or are flat-out untrue.  But the spokespeople for the stories are also contrived.  First, they tried using actors as "spokespersons."  That didn't work out so well, so then they started picking family/friends/associates of reliable GOP people to do their talking.  Never reach out to hear stories from ordinary people who can't be managed.  So far, hardly a single"Mrs. Smith Goes to Washington" in the bunch.  

    Might Emily be a rare exception to this pattern?  I'm skeptical.

  •  Okay - this is where I call bullshit (9+ / 0-)
    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.
    Under the ACA, you cannot be made to pay more than 9% of your income annually on total health costs. Doing the math, and only qualifying for a $15 premium subsidy, puts her income up to close to six figures. If that's the case, then how on earth did she qualify for CoverTN?

    Money should be treated like any other controlled substance; if you can't use it responsibly then you don't get to use it.

    by La Gitane on Fri Feb 28, 2014 at 12:11:55 PM PST

  •  She's not "a loser." She is spared... (1+ / 0-)
    Recommended by:
    JayBat

    from having to cover every dollar over $25k that she would incur under her POS high-risk plan. And she is spared for the likelihood that she get dumped by that plan the next time her costs require a lottery win.

    Just because she caught a break the last time she racked up a massive bill doesn't mean she will be so fortunate the next time she needs treatment. And given her condition, its not a matter of if but when.

    Of course, I guess under her old plan she could have just declared bankruptcy and once again had others pick up the tab that are inevitably passed along by the hospital.

    Isn't it funny how quickly the Kochs will highlight a prime example of a "taker" when it suits their purposes?

  •  My wife has Lupus. Obamacare has been (7+ / 0-)

    a blessing. She left the Texas High Risk pool and for the first time in over a decade the entire family was able to be on one policy. Our monthly bill dropped as well even when we added a dental plan. I wrote about it here => http://egbertowillies.com/...

  •  No non-destitute person should pay $52/month (1+ / 0-)
    Recommended by:
    TKO333

    ...for insurance.  That's just fobbing the expense onto others.  So leaving aside all of the details, I am totally comfortable saying she was paying too little.

    It's not the side effects of the cocaine/I'm thinking that it must be love

    by Rich in PA on Fri Feb 28, 2014 at 12:29:20 PM PST

  •  Props in this "ad" - (0+ / 0-)

    I noticed 2 things  1) She is shown with several dogs;   2)  She is shown with several nice collections of pill bottles.  

    Most of the pill bottles shown are light orange - but some are deep green.   Around here it is the practice of veterinarians to dispense pet meds in those dark green containers.  This is just so they don't get mixed up with 'people' meds.  

    But in this case it adds to the impression that this woman takes all the medicines shown.  Now, knowing a young woman with lupus, I know that there is a high number of meds needed to keep her functioning well - but let's not exaggerate.  Some of the pills shown may be for her husband, too.  

  •  ACA-dar had this debunked 3 weeks ago: (1+ / 0-)
    Recommended by:
    sharman

    Emilie's story

    Cheers.

    Against stupidity the gods themselves contend in vain. Friedrich Schiller

    by databob on Fri Feb 28, 2014 at 04:56:24 PM PST

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