WHAT’S BEHIND THE CHANGES
Insurance plans and costs change every year. Even so, the Affordable Care Act will have a major impact on some portions of the insurance market in 2014.
The law requires that health plans offer a list of 10 “essential health benefits,” including outpatient care; maternity and newborn care; mental health and substance abuse services; no-cost preventive services such as colonoscopy, mammography and vaccinations; and dental and vision care for kids.
Plans sponsored by large employers typically cover nearly all those benefits already. In the individual insurance market, however, things are different. Each plan purchased by an individual must cover all of the law’s essential health benefits. Plans offered on the Health Insurance Marketplace meet these requirements. But other individual plans generally do not. So insurance companies must enhance their individual coverage, and they’ll make customers pay more for it – or cause them to look elsewhere for a better deal.
— Staff report
OBAMA TO PUSH LAW
President Barack Obama heads for Boston today to draw parallels between his health care overhaul and Massachusetts’ landmark 2006 health law. After Massachusetts first passed its law, the rate of people signing up grew only sluggishly at first. But as deadlines approached, the pace picked up. And today, the law remains popular. It even provided a blueprint for Obama’s law. But while more people did sign up as the deadline approached in Massachusetts, its law never faced the kind of high-profile computer woes plaguing the federal law, nor the predictions of failure the federal law has — in part because it had bipartisan support, including from then-Gov. Mitt Romney, who signed it into law; the Democratic-led Legislature; and the business and health care communities.
— Associated Press
On top of its ongoing website woes, the Obama administration on Tuesday confronted a new problem with its health care law: a wave of cancellation notices hitting individuals who buy their own insurance.
Medicare chief Marilyn Tavenner testified before the House Ways and Means Committee that it’s not the administration but insurers who are responsible for cancellation letters now reaching many of the estimated 14 million people who buy individual health insurance policies. Tavenner said people who get cancellation notices will be able to find better replacement plans, in some cases for less.
But that did little to placate lawmakers, who grilled her relentlessly about the new difficulty in the law’s rollout.
The issue surfaced after NBC News on Monday quoted four unnamed people it said were “deeply involved in the Affordable Care Act” as saying up to 75 percent of the 14 million consumers who buy their own health insurance could expect to receive cancellation letters next year because their existing politics don’t meet the standards mandated by the new law.
Insurance policies in effect when the law passed on March 23, 2010, were supposed to be grandfathered, but the report said subsequent regulations narrowed requirements, causing many to fall out of compliance.
“Yet President Obama, who had promised in 2009, ‘if you like your health plan, you will be able to your health plan,’ was still saying in 2012, ‘If [you] already have health insurance, you will keep your health insurance,” the report said.
Insurers said it was easier to cancel policies and write new ones than to try to make the older ones comply. The cancellation notices are now reaching policyholders, and they have been complaining to their lawmakers, who demanded answers from Tavenner on Tuesday.
“Based on what little information the administration has disclosed, it turns out that more people have received cancellation notices for their health care plans this month than have enrolled in the (health care website),” said Ways and Means Chairman Dave Camp, R-Mich. He cited a news report of 146,000 cancellations in his state alone.
Up and down the dais, lawmakers chimed in with stories of constituents who had received similar notices. Republicans offered examples of people being asked to pay more.
Democrats countered by citing constituents who had been able to find lower-cost coverage than they have now. Ranking Democrat Sander Levin of Michigan said one of his constituents has been paying $800 a month for a BlueCrossBlueShield plan and managed to find comparable coverage for $77, after tax credits that lower the premiums.
Still, Levin added, “This has become a matter of legitimate discussion.”
It could take months to sort out the balance of individual winners and losers. There’s not a central source of statistics on how many policies have been cancellations. Even the number of people who buy insurance individually is disputed.
Tavenner denied the administration was to blame.
“In fact the issuer has decided to change the plan,” she said. They “didn’t have to.”
The White House also weighed in Tuesday, with spokesman Jay Carney saying the changes are part of a transition to better coverage.
“The good news is that for every one of these individuals who might have a plan that is almost by definition providing less than minimal benefits … you are now being offered a variety of options, including options by the very insurer that covers you already, for new coverage,” he said.
But critics compared it to an airline forcibly upgrading passengers from economy to business class, where they might be required to pay a higher ticket price.
Tavenner, in the hearing, also delivered the most direct mea culpa yet from the administration for the technical problems that have kept many Americans from signing up for coverage through HealthCare.gov.
“I want to apologize to you that the website has not worked as well as it should,” she told the committee.
The first senior official to publicly answer questions from lawmakers, Tavenner was pressed not only on what went wrong with the website, but also whether lawmakers can trust recent promises that things will be running efficiently by the end of November.
She declined to provide enrollment numbers, repeating nearly 20 times they will not be available until mid-November. But she did try to lower expectations of a strong initial sign-up, saying, “We expect the initial number to be small.”
The administration expected nearly 500,000 uninsured people to sign up for coverage in October, the program’s first month. Committee chairman Camp told Tavenner that by his math, the administration appears headed for less than a fourth of that.
Outside contractors testified last week that there was not sufficient time to test the complex online enrollment system before it went online.
About the Author
