Affordable Care Act Pt. II: ” You Can Keep Your Plan…”

The Basics:

The President has repeatedly said “if you like your plan, you can keep your plan.” This assurance meant that if an individual or family had insurance on their own, through their employer, or from the government, they wouldn’t be forced to change those health care arrangements, including things like seeing the doctor you like, designating which hospitals you can visit, and paying for the services you need at the price that is most affordable.

 

The goal was for the uninsured or people who didn’t like their current plan to switch into the new exchanges to choose a federally approved plan. From the more limited Bronze plan to the comprehensive Platinum plan, people could choose to enroll in the exchanges. The President promised that no one would be forced to enter the exchanges, and included a “grandfather clause” into the bill to protect existing plans that people were happy with.

 

The Problem:
Over five million Americans are losing their health insurance, despite the President’s promise. This is because the grandfather clause was written so loosely that any change to a deductible, co-pay, or premium makes it ineligible. While the administration acts surprised that this is taking place, a 2010 report clearly shows the President knew between 40% – 67% of plans could be cancelled.
 
While this is devastating to the individual market, there is no guarantee that employer based plans are any less likely to see the same fate. The same 2010 report indicates that over 50% of employer based plans could be cancelled.
 
Serious backlash has been escalating despite the administration’s attempt to rationalize these losses by saying “it’s a small percentage of the population” or that “these are substandard plans.” Tell that to Edie Sundby whose “bad apple policy” got her the cancer treatment with the doctors she wanted. Millions of Americans feel cheated and deceived. Worse still, they can’t even get a new plan through the dysfunctional exchange website!
 
Where do we go from here?
The President and Congress have crafted proposals to fix the cancellations, but it’s very difficult to reinstate these policies. Insurance companies have been complying with the law for three years, and state insurance boards would need to quickly approve of the policies.
 
In the meantime, the website must be up and running so that, at the very least, people have an option to get new insurance. Initially, and for months after the launch, the website was not an option. Meanwhile, costs continue to rise for the website even a year later. One overarching solution would be for the President to waive all minimum benefit regulations for health plans, but the administration would never accept such a proposal.