The large for-profit private insurance company Anthem Blue Cross has found a clever new way to screw over its consumers even if they have been diligent about paying their premiums on time over the years. I encourage everyone to read the entirety of this article in the LA Times:

[Andrea] Kreuzhage has been making automatic payments to the company by credit card for more than a decade. “It’s more convenient,” she said. “I never have to worry about missing a payment.”

But after receiving the letter about her coverage being canceled, Kreuzhage called Anthem and was told that the insurer was no longer charging premiums to her credit card.

Nobody at Anthem had called to warn her that her bill wasn’t being paid, she said. The company didn’t bother to send an email. It just waited for 30 days to pass and then cut off Kreuzhage’s coverage.

To add insult to injury, Anthem planned on charging people a $15 fee to pay their premiums by credit card, but has suspended that plan for now due to an issue with state law.

This is why I thought it was such a horrifyingly bad idea for the Democrats to use the force of law to make Americans become the consumers of only the private health insurance industry. Even though the Affordable Care Act has some new regulations, enforcement is weak and left up to the states and the new state-based exchanges that are already becoming dominated by the health care industry. I have little doubt that even with the new regulations, the for-profit insurance companies will find inventive new ways to bend the rules to screw over regular Americans.

The power imbalance between a large corporation and a very sick middle class worker struggling with mounting medical bills is too great, and the regulator scheme in the ACA is nowhere near robust enough to compensate.

If the ACA contained a public option, even if it didn’t have a significantly cheaper premium, the American people would at least know there was one plan they could choose that wouldn’t be looking for loopholes to use to screw them over. The public option would have served as a powerful yet indirect regulator by providing a benchmark for consumer service.

Don’t let anyone tell you that the Democrats’ decision not to include a public option wasn’t a massively important policy detail. The decision to throw the low income American people to the wolves without a guaranteed safe harbor radically changed the entire nature of the law.