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Misrepresentations in the Affordable Care Act

January 23, 2014
Matt Kokkonen

Matt Kokkonen

OPINION By MATT KOKKONEN

“If you like your insurance, you can keep your insurance, period. If you like your doctor you can keep your doctor, period.” Obama was selling Obamacare to us and advocating that those insured with “grandfathered policies” should change them to the “superior” Affordable Care Act ones.

Let‘s evaluate Obama’s sales pitch and multiple blatant lies in light of California insurance code:

“Insurers and producers are prohibited from making, or allowing others to make statements estimates, illustrations, circulars, or other communications, whether spoken or written, that are known, or should be known to be a misrepresentation of (Policy Terms or Benefits).

“Misrepresentations may not be made for the purpose of persuading:

• A consumer to purchase a policy.

• A consumer to refuse a policy issued by another insurer and instead purchase one from the insurer or producer making the misrepresentation.

• Persuading a policyholder to lapse, forfeit, change, or surrender a policy.

Making misrepresentations is punishable by:

• A fine of up to $25,000.

• In a case in which the victim’s loss exceeds $10,000, a fine up to three times the amount of the loss suffered.

• Imprisonment in a county jail for a period not to exceed one year.”

Who says Obama is or should be above the laws that commoners have to live by?

Matt Kokkonen is a Chartered Life underwriter and a Chartered Financial consultant in San Luis Obispo. Contact him at (805) 541-1880 or (805) 886-1880.


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The Obama administration is the most corrupt ever. From blaming and jailing a filmmaker for Benghazi, to charging journalists that are critical of Obama (Dinesh Dsouza), to going after moodys for downgrading US bonds. For all of his lavish vacations on the taxpayers dime. Giving weapons to Mexican drug cartels, Using the IRS to destroy political opponents, Using the NSA to spy on all Americans. Could go on forever


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Corrupt? Certainly — and probably in ways you don’t want to acknowledge since they also apply to the politicians whose kool-aid you have been drinking (based on some of your critiques which are restatements of political propaganda.) He is corrupt in that he is as much a tool of the corporate socialist movement as most of his GOP opponents. There may be some differences in which corporations own which politicians, but the end result is the same.


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now watch this drive


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Obama is a many things, but he is not the most corrupt ever. Ever hear of the Teapot Dome Scandal?


More recent corrupt presidents are the Reagan, Bush 1, and the Bush 2 administrations.


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Obama is the most dangerous president in our nation’s history. Period.


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Why? Tell us how you came to this conclusion. Then compare your “most dangerous” diagnosis as compared to the likes of Nixon, Reagen, Daddy Bush, Baby Bush (and those are just from recent history). You won’t take the time because when it comes right down to it, his, Obama’s, “dangerousness” can’t hold a candle to these past megalodons of true danger that affected all of us, and still does!


Like most who spew this kind of fear mongering BS they side step facts and practice the age old ideology of the far right… “Say it often enough and it becomes truth.”


Just sayin’…


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Edith thought Archie said FDR was the most dangerous


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I usually agree with you, Danika, but not on this.


I believe Bush Jr. was the most dangerous president in our recent past because he was not capable to be president. Because of that, he allowed heinous people like Duck Cheney run our country for him.


The result was our nation was lied into a war to gain power in a Middle Eastern oil-producing region, the result of which was our nation’s best and brightest were shipped off to sacrifice on the bloody altar in the Middle East we call Afganistan and Iraq.


This has left us a bleak, tragic and expensive legacy of damaged soldiers, many of which will pass on that legacy to their loved ones. But it will be the ones closest to them, especially their children, whose lives and futures will suffer the most.


Meanwhile, Duck Cheney’s Halliburton gutted our nation’s resources–human and financial–leaving us a far less powerful nation, unable to play the important stabilizing role in our world.


Obama is a bait-and-switch huckster of a president, but he isn’t’ close to Bush Jr.


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For dismantling the EPA for personal financial gains through natural gas…..Etc..and on and on…hey and some voted Twice for him!


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I’m sorry, who are you referring to? Bush Baby or Obama?


Just sayin’…


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Many people voted twice for Obama. Needless to say, I wasn’t one of them.


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Since you bring up an easy to poke-in-the-eye reference, you better read this latest development about your Dinesh Dsouza fellow: http://www.motherjones.com/politics/2014/01/dinesh-dsouza-indictment-dartmouth-outed-gay-classmates


Seems there are irregularities with his campaign finances, besides other, questionable behaviors and matters.


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It is good to hear from an unbiased source on the critical subject of health insurance.


Certainly Mr. Kokkanuten has no skin in the game as an insurance agent, and is totally neutral as to his personal political allegiances.


The fervor to denigrate the ‘Affordable Care act’ implementation has been unrelenting, and seems to have been well financed by whom?


Who would have the most to lose by the success of the ‘Affordable Care Act’?

Maybe the folks that have had a lock on selling individual ‘health insurance’ plans?

Only a guess.


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I agree that government officials should be held to the same legal standards as the rest of us. I also think that corporations and their executives should not get excuses because of their political influence or ability to use lawyers to grind the legal processes to a halt. Mr. Kokkonen may or may not be right about legal favoritism in this case. (Were Obama’s promises intentionally deceptive on this subject or the result of poor information or the result of obstructionism by his opponents?) While I agree that Mr. Kokkonnen is far from an unbiased source, there are legitimate arguments against the ACA.


I personally agree that the Affordable Care Act is bad — but for very different reasons. There should have been a single payer option to force the greedy and unethical health insurance corporations to compete with an organization whose main drawback is bureaucratic incompetence. (It did even less to limit the greed of pharmaceutical corporations.) Mr. Kokkonen and most others who rail against the ACA either forget or refuse to acknowledge the systemic abuses that such companies engaged in — which provided the political base for the Act in the first place.


My gripe about it is that their congressional puppets left back doors open in passing the act which allows these SOBs to keep a major hand in the system with only a couple of significant reforms as penalty for their past misbehavior and no real incentive to become honest businesses. As passed, the ACA allows them to keep profiting from the system while adding the expensive and inevitable layer of governmental bureaucracy instead of replacing them with it.


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I so totally agree with your opinion about a single-payer system. That is what Obama promised and he pulled a bait-and-switch scam into the ACA.


Still, the ACA is better than the old bend-over-and-pay-what-we-want-to-charge-you scam run by the insurance industry.


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Any man who thinks he can be happy and prosperous

by letting the American Government

take care of him

better take a closer look at the American Indian.”

Henry Ford


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Cherokee Nations doing well enough to take care of tribe members and their relations, thank you very much Mr Ford


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Discovering oil on your land and having the President of Phillips Petroleum as your chief certainly didn’t hurt any either.


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And how much in government subsidies have been paid to the Ford Company?


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Actually Ford was one auto company that didn’t accept any money during the bailouts and you can be sure that Henry Ford didn’t take any subsidies.


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Who says Obama is or should be above the laws that commoners have to live by?

——————–

Don’t know.


Ask Attorney Stewart Jenkins because about a month ago an article from him ran here saying how great the new health care act was and how easy and affordable it was to sign up for it. What say you now Attorney Jenkins?


Now the reality is setting in that the working young people don’t want to pay 4-5 times their current rates just to pay for the healthcare of the old, the sick and the welfare takers so they are just going to go without insurance and pay the lousy $95 tax at the end of the year. And this is especially true since the low end policy–I think they call it the bronze- has a $5,000 deductible and then only covers something like 70% of your healthcare costs. With premiums for this lack of insurance starting at about $300 per month or $3,600 per year, it’s no wonder the young people are taking their chances and just dropping insurance altogether.


And if you didn’t like the lie about being able to keep your current insurance wait until you research what “co-insurance” is and how your new bronze policy is going to require your “co-insurance” to cover about 30% of your healthcare payments should you get sick. “Co-insurance” is a lying word for no insurance. “Co-insurance” means your insurance company won’t be covering 30% of your health care costs and that that 30% is your problem–on top of the first $5,000 being your problem.


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And, don’t forget, Obama is an immigrant, a communist (whatever that is), he hates capitalism, he wants to take our guns away and I’m pretty sure, according to a tabloid (subscription) I just got in the mail, wife Michelle is ready to divorce him because he’s an adulterous philanderer preferring hot-looking leaders of state. It must be Tea time ‘cause I smell a big pot of it brewing here.


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You might want to pretend you’re in Denver, Randy, and roll one up. Time to relax a bit, life is too short


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Randy Sheila, Are you trying to say that Barry didn’t have anything to do with “Obama Care”

that this medical insurance mess is just a figment of our imagination, and yes he has tried to take our second amendment away. Do you think Tea Party members are some how connected to articles printed in Tabloid magazines. Remember, when you throw dirt…. you lose ground……


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Ah, Sheila, now the truth comes out. You were absent those weeks for the part in you History class where they taught the young folks about Communism, thus the comment “(whatever that is).” Or maybe they just don’t allow students to learn about it anymore in publics schools. All in all a much better idea. All the better to sneak it in on the fools so they can’t see it coming because the don’t know what it looks like.


Sigh…but you have learned about the Tea Party, right??? From, let’s see…MSNBC??? Since you subscribe to the tabloids I figure that must be your station of choice!


By the way I don’t think any of us here are foolish enough to believe that Oblamer hates Capitalism. He has garnered plenty of capital just in the years he has been in the White House and he seems to be enjoying that just fine.


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I am a life-long Democrat, but am a strident critic of Obama and the Obama administration.


One of the reasons I voted for him was because he promised a revamp of our health-care “system” in the U.S. to one that would be more affordable and would insure people who could not obtain/afford insurance before.


I was formerly covered by a Blue Shield HMO because it was what I could afford. The coverage was just terrible. To make a long story short, a problem that should have been addressed immediately by my primary physician was misdiagnosed (the misdiagnosis was evident to a layman) and allowed to go untreated for months before I could get the physician/group to refer me to a specialist. The problem turned out to be something that could have taken my foot, my leg and/or my life.


Previous to the Blue Shield HMO coverage, I had coverage by Blue Shield PPO. I had no problems receiving adequate care under the PPO coverage.


I signed up under California Covered, to the top-of-the-line PPO coverage with Blue Shield. No deductible, very low co-pay, and a wide variety of physicians and facilities available.


Here’s the best part…my monthly premium is $400 LESS than the piece-o’chit HMO.


There are still problems with the ACA, primarily Obama’s gift to big pharma of continuing to not require competitive pricing from the pharmaceutical companies, something he did before the pharmaceutical companies even had to ask for it. The costs for the ACA from this one Obama give-away could have greatly decreased the costs to the people of America.


However, from where I–and many others–sit, the ACA is a success because it delivered one of the things it promised…lower premiums which, in my case, was about one-half of what I paid before for insurance.


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Well Mary you are seriously fortunate, because I and most other people who I talk to who purchase their own insurance (not through their employer), Obamacare is a DISASTER. In my case, my monthly premiums started rising from $120 at the time Obamacare passed to $300 now (Blueshield). Nonetheless it was “decent” insurance. They have now cancelled it,


Previous:

– $300/mo

– $2,500 deductible

– 3 primary care visits and 3 specialist visits per year pre-deductible

– ER visits $100 pre-deductible

– 100% inpatient care and outpatient surgery coverage after deductible


Here’s the new plan with “higher standards”


– $320/mo

– $5,000 deducitble

– 3 primary care visits (2x the price) pre-deductible, no pre-deductible specialist visits

– ER not covered pre-deductible

– 60% coverage of ER, inpatient care, & outpatient surgery


So that’s great that you got a higher level plan and saved money. But that didn’t happen forthose of us on the lower level plans… ironic.


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I went from a much-lower-level Blue Shield HMO to a top-of-the-line Blue Shield PPO, and at one-half the monthly premium.


I know others who have also saved significantly under the California Covered Affordable Care Act health-care insurance programs.


I am sorry not everyone (including you) didn’t have the same results. However, you may in the future.


Understand, this is just ONE of the many election promises Obama made, the majority of which he has broken. One of the promises was to make big pharma competitive for medication prices, which–as I previously noted–he caved on before he was even asked by big pharma.


I still consider Obama one of the worst bait-and-switch presidents I’ve experienced in my lifetime and, considering the contenders for the prize, that is saying quite a lot. But in this one case–the ACA–he did (mostly) what he promised.


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Who is paying for the rest of your policy!. Are your tax dollars going to bail out the insurance companies as it states in the obamacare bill. The insurance companies are already being downgraded by Moodys http://thehill.com/blogs/healthwatch/health-reform-implementation/196203-moodys-downgrades-health-insurers-over The problem is that, healthy working people cannot afford the increase in rates to pay for all those subsidies. The states are being overwhelmed by the increased Medicaid patients This this is a disaster.


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Moodys? Please clarify how a company that had a huge hand in the 2008 crash (along with Standard & Poor’s ) should still be considered a credible point of reference in any conversation? Let alone one about the Affordable Care Act? The only way it can be is to those 20% who partake in 80% of the stock market in this country, AND, still trust these purveyors of corruption and fraud…To the rest of us….?


“The states are being overwhelmed by the increased Medicaid patients” According to whom? Here’s what some in the know say:


“There is going to be a quick surge because there are so few providers willing to serve the Medicaid population. It is a concern but not a major one. I think it would have been much of a concern if more states have taken the Medicaid expansion.” Dan Hawkins, senior policy official and lobbyist for the National Association of Community Health Centers.


“There probably will be an uptick, but not everybody that’s newly insured has pent-up demand. Their sort of initial access to services will be spun out over time.” Jeff Goldman, vice president for coverage policy at the American Hospital Association.


Just sayin’…


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Keep drinking that Kool-Aid. It’s going to be even worse as employers drop coverage and force employees to the exchanges. Obama gave them a reprieve till the end of this year, but it has already started. Its also true many middle income families are finding ways to lower reported income to be able to qualify for Medicaid and other subsidies. Its a disaster, and were not even talking about quality of care as all those new Medicaid patients get pushed into the local CHC offices because most doctors don’t take Medicaid


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If employers drop coverage without subsidizing enough’ s costs for ACA coverage, that is the employer’s decision. It is not the fault of the ACA.


Workers may want to consider joining unions. This is exactly the type of situation where union bargaining protects the worker.


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The insurance companies brought this on themselves. The greed-is-good business model only works up to a point, and the insurance industry whores passed that point a LONG time ago.


Before the ACA, I paid $800 a month for my insurance…AND it was a lower-level HMO…AND I was “lucky” to get the coverage because I had a very minor pre-existing condition.


So don’t even start about the fallout on the insurance industry because it is due to their own avarice and greed. They chose the greed-is-good business model and assumed there were no limitations to the model.


Well, they guessed wrong, so the fault lies with them for the repercussions of their actions.


Or, as Fred Zappa wrote: “Do you love, do you hate it? There it is, the way you made it…”


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Gutting the insurance industry and the pharmaceutical industry in one swoop would have destabilized the country.


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My insurance went up $300 a month, and I now have to pay for Pediatric Dentistry.

I have had my teeth for a very very very long time…

People are complaining about the cost, but just wait until they actually require medical care……….been there, and done that.


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I agree with you here Mary and I think that more Americans will benefit from the rate changes than will lose. However, Mr. Obama and his supporters did over-promise on this subject — whether intentionally or not. I can understand the frustration of those who will be paying more than before — some for less benefits. I wonder how many of them would be less upset if they had experienced the abuses so many others of us had by the health insurance industry prior to Obamacare.


However, after congress got through inserting loopholes and indirect corporate subsidies in the ACA, the costs (partially underwritten by taxpayers) may well be too excessive for the few benefits it provides. Anyone with any fiscal sense at all would have known that overall health system costs under the ACA were likely to be at least as much as the costs under the old system IF it had been well designed. (Political promises to reduce costs should always be accompanied by a notice to put on tall rubber boots.) It wasn’t well designed and we’ll be paying more for it as a result.


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Congress was not responsible for the biggest problem with the ACA. That failure lies at the feet of Obama. Before congress ever got involved, out of the blue, Obama declared the ACA would not require competition between pharmaceutical companies for contracts with the government on drug prices. Having big pharmaceutical forced to compete by lowering their prices was going to pay for a big hunk of the ACA costs.


I think the way this is going to shake out is, after the first year, the government will revisit the drug-competition issue because they will have to shore up the program financially.


Other savings will come from a decrease in visits to the ER, surgery, etc. by the uninsured.


Eventually we will end up in a single-payer system. However, in the interim we have to wean off those who profit from the dysfunctional system.


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You are far more optimistic than I am. I don’t think there is enough political will or consensus to make any significant changes to the ACA. The political lines have been drawn and neither side will back down if the other proposes changes.


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Let’s revisit Mary Malone’s feelings on her ACA plan a year from now. When the reality has hit her pocketbook.


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I believe it is more of a probability that those whose income depends on the previous model of the insurance industry will take a financial hit from the ACA. My hope is that those who work in the trenches–our local insurance companies–will be an exception to that outcome.


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I am not an Obama fan by ANY means but lets be fair. The laws you mention I bet pertain to insurers who can persuade clients to make profit. Obama is not persuading for profit. Legacy yes but he will not personally make money so I think you have a hard case to prove.


It’s kind of like suing the Government. You can but they don’t have to pay. Same here. I don’t see where he is benefiting so I don’t see why going after him on this. Bengazi, IRS scandal and others yes but this? I don’t want to start going after elected Presidents for stuff like law making, other than to make sure legal, otherwise we are going to end up with a cluster f**k of a Government. Yes it is already but it will make it worse in my opinion.


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I have no doubt that the Affordable Care Act will go down in history as one of the worst laws ever enacted by Congress. It was ill conceived and no one bothered to read it before voting.


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These laws do not apply to a dictatorship, even if it has the appearance of a Democracy. This is why,” For The Republic.”


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