“If you like your current insurance, you can keep it” – yeah, not so much

Now that the Obamacare Healthcare.gov website launch debacle is passing out of the news cycles, this means of course new issues are coming up, including one that may never have been avoidable. But should have been.

It’s a truism in American mass media these days that we no longer do nuance.

Sarah Palin’s Obamacare “Death Panels” kept getting all the press because (1) it’s a simple idea, and (2) it’s scary as all hell for those gullible (or stupid) enough to believe it.

The fact that there is no such thing as Death Panels didn’t matter, nor was there much traction whenever pundits, commentators, and even the few remaining real journalists kept pointing out “If there are ‘Death Panels,’ they exist right now in your for-profit insurance company — the one that just denied coverage for your life-saving operation. The government won’t have a profit motive to try to deny you coverage.”

Or, as was my case in 2003, the ‘Death Panel’ that decided to stop underwriting the group insurance plan I was enrolled in, and threw us all out onto the individual insurance market. A market where I spent most of the next decade uninsured because I could not buy individual insurance at any price due to ridiculous pre-existing condition denials due to seasonal hay-fever allergies and migraines.

Why? Nuance. It’s easier to sell a simple, crazy lie based on lizard-brain fears than it is to sell reality that requires even a smidge of rational cognition and critical thinking.

A lot of you can’t keep your insurance

One of the lines nearly everybody remembers from Obama’s stump speeches on his signature health insurance reform plan — the Patient Protection and Affordable Care Act (PPACA) or ‘Obamacare’ — was he kept saying, “And if you like your current insurance, you can keep it.”

They knew from the beginning this would not be entirely true for many. “You can keep your current insurance” is simple, straightforward, and reassuring to lots of folks who don’t think things through. However, Obama should have realized eventually the truth would come out, and the fact of that statement being not 100% as portrayed would get far more press than the nuanced truth.

It was a dumb thing to tell people. It was dumb when they knew in 2010 that “40% to 67%” of people on the individual market wouldn’t be able to keep the same insurance policy, and an even more boneheaded move now that we know it’s more like 80% in the individual market.

obamacare-exchangesAnd now, they’ve lost control over messaging, again, as the media is reporting (not entirely correctly) that hundreds of thousands of people are finding their insurance policies “canceled” because of Obamacare.  Now, that claim isn’t entirely true – the policies aren’t canceled (people are being moved to other policies) and it’s not really because of Obamacare (it’s a decision made by the insurance companies).  And in a show of where their true loyalties lie, the insurance companies are doing all they can to whip up the hysteria. Why? Because the status quo ante was a situation where profits would climb even faster than under the new PPACA (aka Affordable Care Act, aka Obamacare) regime.

The reason so many people with individual policies are getting letters now from their insurance companies, and why employees of companies are being told they have to change their plans next year is because, right now, their current insurance stinks. Or more accurately, it fails to meet the new PPACA-mandated coverage requirements. Among the most common reasons:

  • Deductible too high
  • Co-pays too high
  • Out-of-pocket maximum too high
  • Plan has yearly or lifetime benefit limits
  • Co-insurance isn’t high enough
  • Plan has coverage exclusions that are no longer permitted (such as for mental health care)
  • Plan doesn’t include prescription medicines, charges too much for them, or has prescription coverage limits (John knows this last one very well)
  • Plan doesn’t include preventive and well-care doctor visits for no charge

Also, keep in mind the situation that has developed over the last 10-20 years. Those with individual insurance like John Aravosis (our site proprietor), who knew the prescription portion of his insurance was lousy, had no option for a better plan.  John had the best PPO plan he could get, his only choice was to dumb-down his plan, pay less, and get even less.  Had he tried to switch to an HMO, they’d have required a physical.  And if my allergies and migraines disqualify me from getting insurance, imagine what they’d do to someone like John who has allergies, asthma, and a past retinal detachment.

Then there are the millions of Americans who felt they couldn’t change jobs, take a sabbatical, or start a new business because they’d lose their employer-provided group insurance.

You might be thinking, “Well, why doesn’t the insurance company just fix the parts they have to and let me keep my current policy?” That’s the rub — and more nuance.

Originally, the Obama Administration was going to ‘grandfather’ a larger proportion of the older, non-compliant insurance policies – like John’s -but over the last year, instead they’ve gone the other direction and tightened the rules considerably.

(The) Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.

My takeaway from this is that even attempts to bring a policy into greater compliance with PPACA’s rules could trigger the exclusion. On top of this, many states have laws and regulations — rules intended to protect people — that prevent insurance companies from changing policies without lengthy approval processes.

Anyway, while I can understand the political rationale in using this “you can keep your insurance” line, it was short-sighted, and I suspect in the near-term will prove to have been an unwise decision.

Being Captain Hindsight here, in my opinion, they should’ve sold it as “your insurance terms will improve considerably, especially if you’ve been living with substandard insurance.” But Obama and his people didn’t, and now they’re going to have to deal with the blow-back.

GOP lies aren’t helping either

Having said all of that, this does not excuse the GOP fearmongering and outright lies about the issue.  The Republicans, who never actually cared if anyone got insurance, are suddenly oh-so-concerned that people might lose their current health care plans.  The thing is, the way the Republicans are portraying it isn’t entirely accurate.  From Politifact:

[GOP Sen. Marco] Rubio said, “300,000 people are going to lose their individual coverage because of Obamacare. Now those people next year, they don’t have health insurance.”

Rubio was referring to letters Florida Blue started sending to consumers in the individual market in August. The letters do tell consumers that their particular plan will end due to the Affordable Care Act. That’s because the plans typically don’t offer the comprehensive coverage that is required under the new law.

However, the letters also state that consumers will have “continuous health care coverage” and assigned them a particular plan, or gave them the option to contact Florida Blue and choose another plan. So their coverage is not dependent on being able to buy insurance through healthcare.gov, the government’s online marketplace.

We rate this claim Mostly False.

I don’t think it helps the administration that all these people are finding out that they have to change plans, but it’s not exactly true to suggest they’re all going to be without insurance next year.  Josh Marshall has a bit more on how the media is mis-portraying this news.

But again, for a public relations perspective, the fact that so many people are getting letters, when they weren’t expect it, will not help the Obamacare cause.

And there’s another question all of this raises: Why didn’t people know that their plans were going to be phased out?  Why didn’t the insurance companies tell them when they purchased the plans?  Or at least tell them it was a possibility (even a likelihood) if the plans were purchased after the Affordable Care Act passed?  John tells the story of looking for a new plan from Blue Cross last month, before the exchanges opened.  They offered him a pretty good plan, better than what he has now, for only a bit more per month.  What they didn’t tell him, until he called back with more questions, was the the plan would be phased out next year because of ACA compliance.  So there’s a serious question here of what the insurance companies knew about these plans, and when they knew – and what, if anything, they did or didn’t tell their customers when they were purchasing the plans.

Healthcare.gov updates

Some of the news I’ve gathered about the Healthcare.gov website over the last few days:

The Obama administration claims Healthcare.gov will be fully functioning by the end of November. We’ll see. It’s been two weeks and my identity remains pending “verification.”

The Healthcare.gov website now has links to try to apply online or to call to sign up. Another option, which might be the best of all (in my opinion) is to download the PDF forms, print them, fill them out, and mail them in. I’m leaning towards this last option, and will probably do so if another week goes by where I can’t sign up online.

The other day, in the comments, I remarked that another possible solution is to bypass the Healthcare.gov website entirely and just go to the health insurance providers in your area. I have to rescind that suggestion, or at least advise using caution when going that route.

The reason is from this post I ran across by BlueIslandGirl on Daily Kos, in which she recounts seeing two policies she thought were the same, but actually were not. By her account, the policy on the insurance company website, despite having the exact same name, had a different premium, co-pay, and coverage — and all the differences were not to her benefit.

John has been asking around about this very question – what’s the difference between buying plans in the exchanges and buying them directly from the insurance company itself – and can’t seem to get an answer.  That’s an obvious question that should have been answered in an FAQ from day one.  But it wasn’t.  Along with a lot of other good questions.

Published professional writer and poet, Becca had a three decade career in technical writing and consulting before selling off most of her possessions in 2006 to go live at an ashram in India for 3 years. She loves literature (especially science fiction), technology and science, progressive politics, cool electronic gadgets, and perfecting Hatch green chile recipes. Fortunately for this last, Becca and her wife currently live in New Mexico. @BeccaMorn

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