Jimmy Kimmel praised Obamacare but left out a few important bits, quite relevant in his circumstance. How might little Billy have fared if his parents had a standard Obamacare insurance plan?
First scenario. Suppose that the Kimmels had a bronze plan with a $12,000 deductible – pocket change for Jimmy Kimmel, but one quarter of the average family income, currently $52,000. To be paid up front. And that’s each year, for a child likely to need regular cardiology appointments, ultrasound and stress tests, catheterization, and possibly medication. Unaffordable to the average family.
Second scenario. Regardless of which type of Obamacare plan the Kimmels had, suppose their particular plan had a narrow network of providers – physicians and hospitals. Not an issue for Billy Kimmel as he was turning blue and needed urgent surgery. What if, instead, he had a heart murmur but was otherwise stable, not turning blue, oxygenating well? He would have been discharged a few days after birth with instructions to see a pediatric cardiologist.
Suppose Cedars-Sinai, UCLA, and Children’s Hospital of Los Angeles were all out of network for his insurance, with the only in-network hospital being one with a mortality rate for pediatric open-heart surgery three to five times the national average.
This is not fear-mongering, but reality, as mortality rates indeed vary widely between hospitals.