Edie Littlefield Sundby, 62, has sparked a renewed debate over Obamacare after a powerful op-ed outlining the cancer survivor’s loss through the new healthcare act.
“I am one of the losers,” said Sundby.
Sundby says that her grievance is not political. She’s fought for almost seven years and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2 percent after diagnosis.
” I am a determined fighter and extremely lucky,” she wrote in an op-ed in the Wall Street Journal. “But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.”
She added; “My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.”
Sundby has spent many hours searching for non-exchange plans but hasn’t found anything that matches.
United Healthcare, which Sundby says has paid $1.2 million since March 2007 to help keep her alive, sent her a letter announcing that the company was pulling out of the individual California market.
Complications stemming from that move have exasperated her. She’s forced to choose between her primary oncologist at Stanford University and her primary care doctors at the University of California because of what Covered California offers.
“Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines,” Sundby writes.
“What happened to the president’s promise, ‘You can keep your health plan?’ Or to the promise that ‘You can keep your doctor?’ Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.
“For a cancer patient, medical coverage is a matter of life and death. Take away people’s ability to control their medical-coverage choices and they may die. I guess that’s a highly effective way to control medical costs. Perhaps that’s the point.”
Sundby’s opinion piece isn’t without critics, though.
Igor Volsky, writing on the blog Think Progress, says that Sundby shouldn’t blame Obamacare (also known as the Affordable Care Act).
“United Healthcare dropped her coverage because they’ve struggled to compete in California’s individual health care market for years and didn’t want to pay for sicker patients like Sundby,” he wrote. “Over the years, it has become more difficult to administer these plans in a cost-effective way for our members,” UnitedHealth spokeswoman Cheryl Randolph explained. “We will continue to keep a major presence in California, focusing instead on large and small employers.”
Analyzing a quote by UnitedHealth CEO Stephen Helmsley, Volsky says that the company plans to let its competitors “swallow the first wave of sicker enrollees only to re-enter the market later and profit from the healthy people who still haven’t signed up for coverage.”
“Sundby is losing her coverage and her doctors because of a business decision her insurer made within the competitive dynamics of California’s health care market,” he writes. “She’ll now have to enroll in a new plan that offers tighter networks of providers as a way to control health care costs and offer lower premiums. Eleven insurers are participating in Covered California and for the first time they won’t be able to deny coverage to Sundby or any other cancer patients.”
