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| HealthCare.gov home page |
The kerfluffle over that has however been overshadowed in the last week by the issue over cancelled insurance. President Obama promised on many occasions going back to 2009 that "if you like your current health plan, you can keep it." Well, as it turns out, that's not exactly so.
Glenn Kessler, the "Fact Checker" at The Washington Post, recently awarded the president a maximum number of hated "Pinocchios" — four — for "Obama’s pledge that ‘no one will take away’ your health plan."
Obama said in a speech to the American Medical Association, June 15, 2009, "... no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what.”
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| President Obama addresses the American Medical Association June 15, 2009 |
Alas, it wasn't, and still isn't, exactly true. Kessler writes:
... a key part of the law is forcing insurers to offer an “essential health benefits” package, providing coverage in 10 categories. The list includes: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
Health benefits packages that lack those features will have to be discontinued as of next year. Some people who get their health insurance through their employers may notice increased premiums to help pay for additional coverage. But hundreds of thousands of those who buy their own insurance are now receiving outright cancellation notices.
In many cases, those unfortunates will have to buy completely new health packages that will probably cost them a lot more.
Yet some luckier ones will get no cancellation notices. They will find that their existing plans were "grandfathered" into the government's implementation of the Affordable Care Act, meaning they can keep them.
The unfortunate ones whose plans were not grandfathered in are very likely ones who bought those plans after the magic cutoff date, March 23, 2010, when the ACA was signed into law. Only individual plans that were in hand prior to that date are grandfathered in.
Those who have to scramble to get new, expensive insurance, says the lead article in today's Washington Post, "For consumers whose health premiums will go up under new law, sticker shock leads to anger," are finding the plans that are claimed by their insurers to be the lawfully mandated replacements for their cancelled plans are way more costly:
Marlys Dietrick, a 60-year-old artist from San Antonio, said she had high hopes that the new law would help many of her friends who are chefs, actors or photographers get insured. But she said they have been turned off by high premiums and deductibles and would rather pay the fine.
“I am one of those Democrats who wanted it to be better than this,” she said.
Her insurer, Humana, informed her that her plan was being canceled and that the rate for herself and her 21-year-old son for a plan compliant with the new law would rise from $300 to $705. On the federal Web site [HealthCare.gov], she found a comparable plan for $623 a month. Because her annual income is about $80,000, she doesn’t qualify for subsidies.
A cheaper alternative on the federal exchange, she said, had a premium of $490 a month — but it was an HMO plan rather than the PPO plan she currently has. “I wouldn’t be able to go to the doctor I’ve been going to for years,” she said. “That is not a deal.”
And both the HMO and PPO exchange plans she examined had family deductibles of $12,700, compared with her current $7,000.
And:
David Prestin, 48, who operates a gas station and diner at a truck stop in Michigan’s Upper Peninsula, was unhappy to learn recently that his premiums are slated to rise from $923 to $1,283 next year under Blue Cross Blue Shield of Michigan. The insurer said it needed to add maternity care to comply with the Affordable Care Act.
The issue of maternity coverage is a sensitive one for Prestin and his wife, Kathie. They had one child seven years ago, but after she had five miscarriages, they discovered she had an immune issue that prevented her from successfully completing a pregnancy.
At the same time, Prestin said, the new plan would reduce coverage for things he and Kathie need, such as free annual checkups.
The Prestins explored HealthCare.gov. They are not eligible for subsidies, but they found a cheaper plan than the one being offered by their insurer. However, there was another problem: It would have required the couple to switch from the doctors they have seen for more than 16 years and travel more than 100 miles from their home to the nearest major hospital center for treatment — in Green Bay, Wis.
And:
After receiving a letter from her insurer that her plan was being discontinued, Deborah Persico, a 58-year-old lawyer in the District, found a comparable plan on the city’s new health insurance exchange. But her monthly premium, now $297, would be $165 higher, and her maximum out-of-pocket costs would double.
That means she could end up paying at least $5,000 more a year than she does now. “That’s just not fair,” said Persico, who represents indigent criminal defendants. “This is ridiculous.”
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| Deborah Persico, whose individual health insurance plan is being cancelled |
In fairness, I have to note that the plans that are now being forced into cancellation by the ACA are ones in which the insureds were able to cherry-pick the types of coverage he/she/they wanted. Don't need maternity coverage? Leave it out. Never expect to need pediatric services? Bypass it. That keeps the buyer's premiums and deductibles down.
But it also keeps dollars from said cherry-pickers from moving through the system to help cover maternity and pediatric care for those buyers of individual coverage who need them but truly otherwise can't afford them. I imagine Marlys Dietrick, who makes $80,000 a year, can scrimp and save and ultimately afford the $490-per-month plan that would make her, sad to say, need to switch doctors.
Yet it's also true that nothing the president said in the last four years adequately prepared Ms. Dietrick — or the Prestins, or Ms. Persico — for this.
