I had this idea yesterday, but Hot Air [1] beat me to it: After a year of happy talk about the political prospects for Obama-care, dismissing conservative concerns as myths, and pushing the bloated program across the legislative finish line at the last, the Times is finally starting to question some provisions of Obama-care.
Just in time for it to make no difference.
First up in the now-they-tell-us sweepstakes was Saturday's front-page story by one of Obama-care's biggest cheerleaders David Herszenhorn, "Faces of Health Overhaul Debate Point to New Law's Complexity [2]."
They were the human faces of the nation's wrenching, yearlong health care debate.
Natoma Canfield of Medina, Ohio, sent a letter to President Obama about no longer being able to afford her health coverage, and he read it aloud to a group of insurance executives at the White House. Then Ms. Canfield learned she had leukemia, helping Mr. Obama illustrate the life-and-death stakes of the often mind-numbing policy fight.
Marcelas Owens, an 11-year-old boy from Seattle, whose mother could not get some treatment for lack of insurance and died at age 27 from pulmonary hypertension, met Senator Patty Murray, Democrat of Washington, at a rally and ended up by the president's side at the bill-signing ceremony. "I don't want any other kids to go through the pain our family has gone through," Marcelas said.
And Molly Secours, a filmmaker from Nashville, who battled uterine cancer, nearly lost her home because of medical bills - even though she had health insurance. Told that she would need a radical hysterectomy, chemotherapy and radiation treatment, Ms. Secours said, "I was consumed with the fear that I'll have to declare bankruptcy."
But if their stories helped the Democrats pass the health care overhaul, a more complicated question is: What will the health care law do for them?
Revisiting their cases illustrates both the enormous potential benefits of the new law, which seeks to insure some 32 million people, and also how the complexity of the health system will continue to pose a formidable challenge for patients and health care providers in the months and years ahead.
Of the cast of Americans who made appearances in the health care debate, Ms. Canfield, who is undergoing chemotherapy and preparing for a bone marrow transplant at the Cleveland Clinic, may have had the biggest role.
Her story led Mr. Obama to hold a rally in Ohio, not far from her home, which helped secure the vote of Representative Dennis J. Kucinich, a Democrat who had opposed the bill. Then, Ms. Canfield's congressman, Representative John Boccieri, a freshman Democrat, cited her in announcing that he, too, would support the bill.
As it turns out, Ms. Canfield's grave illness means that her time as one of the roughly 50 million uninsured Americans was brief. In recent days, she was approved for Social Security disability benefits and Medicaid, the federal-state insurance program for low-income people.
Sunday's front page brought "New York Offers Costly Lessons On Insurance [3]" by Anemona Hartocollis, which talked about the "unplanned consequences" (a favorite conservative topic) of New York State's "stringent requirements" on insurance companies.
When her small executive search firm in New York City canceled its health insurance policy last year because of the recession and rising premiums, April Welles was able to buy her own plan and still be covered for her cancer and multiple sclerosis.
She was lucky to live in New York, one of the first states to require insurance companies to offer comprehensive coverage to all people regardless of pre-existing conditions. But Ms. Welles, 58, also pays dearly: Her premium is $17,876 a year.
"That's a lot of groceries," she said.
New York's insurance system has been a working laboratory for the core provision of the new federal health care law - insurance even for those who are already sick and facing huge medical bills - and an expensive lesson in unplanned consequences. Premiums for individual and small group policies have risen so high that state officials and patients' advocates say that New York's extensive insurance safety net for people like Ms. Welles is falling apart.
The problem stems in part from the state's high medical costs and in part from its stringent requirements for insurance companies in the individual and small group market. In 1993, motivated by stories of suffering AIDS patients, the state became one of the first to require insurers to extend individual or small group coverage to anyone with pre-existing illnesses.
....
Healthy people, in effect, began to subsidize people who needed more health care. The healthier customers soon discovered that the high premiums were not worth it and dropped out of the plans. The pool of insured people shrank to the point where many of them had high health care needs. Without healthier people to spread the risk, their premiums skyrocketed, a phenomenon known in the trade as the "adverse selection death spiral."
Contributing writer Roni Caryn Rabin contributed more skepticism that Obama-care would actually benefit the uninsured in "Benefit for Uninsured May Still Pose Hurdle [1]," for Tuesday's Science section:
William Mann of Pittsburgh earns just enough to get by. He is 46, doesn't own a car, hasn't taken a vacation in three years and hasn't had health insurance for most of his adult life.
He is just the kind of person who should benefit from the health care overhaul, and he is, in fact, eligible for heavily subsidized insurance that will cost him an estimated $1,845 a year, while the government contributes about $2,756.
But Mr. Mann says he still can't afford it. He lives too close to the edge, and won't be buying insurance, even though he will face a fine under a provision called the individual mandate, which penalizes most Americans who don't buy coverage starting in 2014. The requirement is one of the most controversial aspects of the overhaul.
....
Legal questions about the individual mandate aside, the choices made by people like Mr. Mann are crucial. One reason the individual mandate was created was to attract as many healthy people as possible to the individual market to offset the demands of the many sick people who will be buying in, and who have medical needs that drive up costs.
Yet no one really knows which way the Mr. Manns of the nation, people struggling in a tough economy, will go.
Rabin even quoted a researcher at the conservative Heritage Foundation who was skeptical that uninsured people would actually start buying insurance.
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