[Ed. – Public policy that requires some people to be losers? Priceless.]
To put her 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.
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.
Anyone with a chronic condition would have opted for the plan with the lowest out of pocket maximum, even with a higher premium, so Lamb’s choice makes sense. But it did mean she faced sticker shock, going from $52 a month to $373 a month, even after her subsidy.
In other words, AFP has managed to highlight a very unique case—someone with a chronic condition who did not face high annual costs.
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.
As we have often noted, there are winners and losers under the Affordable Care Act. The Obama administration erred in suggesting that everyone will be a winner and that nobody would be forced to give up a plan that they liked.
But AFP takes it to the other extreme, highlighting a unique case to condemn the entire law.