Remember Edie Sunbdby

The Affordable Care Act is the policy story of a generation. The lesson of its failure, or worse, it survival, will shape how Americans think about big government for decades to come.

One story that I hope is not lost in the sound and fury is that of EDIE LITTLEFIELD SUNDBY.  Hers is the compelling reality of a cancer survivor who is being stripped not only of a good insurance plan, but also of the care of her doctors. Remember Edie Sundby the next time an ACA cheerleader claims that only substandard plans are being erased. Excerpted here, in her words, from today’s Wall Street Journal:

You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).

So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive—but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.

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.

One response to “Remember Edie Sunbdby

  1. Did you fact check why she lost her plan? If it was previously comprehensive, then it likely wasn’t canceled by the ACA, but was canceled by the provider. That provider could likley no longer afford to offer this expensive yet comprehensive plan to only the sick who would still want to stay on it. If healthy people can find cheap, affordable plans, then they can no longer subsidize Edie and Edie’s insurer, not the ACA will cancel her plan.

    I just googled, here’ s the answer. UHC pulled out of California. Not canceled by the ACA.
    http://thinkprogress.org/health/2013/11/04/2881581/

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