The NBC News investigations unit is reporting that “50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a ‘cancellation’ letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law” – a fact administration officials knew but kept from the public.
The cancellations are a result of so-called grandfather rules promulgated by President Obama’s Health and Human Services. The rule exempts health insurance plans in existence before March 23, 2010 – the day the Affordable Care Act became law – from many of the new regulations, benefits standards and consumer protections that new plans now have to abide by, but says that policies could lose their designation if they make major changes.
Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”
What NBC is saying is: that means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.
This all sounds very ominous until you consider that the naturally high turnover rate associated with the individual market means that it’s highly unlikely that individuals would still be enrolled in plans from 2010 in 2014. In fact, the Obama administration publicly admitted this when it issued the regulations in 2010, leading Republicans like Sen. Mike Enzi (R-WY) to seize on the story in order to push for repeal of the grandfather regulations.
The goal of grandfather regulations is to allow a consumer to keep their existing policies, while also ensuring that there are some basic patient protections built into these plans. If insurers make changes that significantly burden enrollees with lower benefits and increased costs they have to come into compliance with all consumer protections. Therefore, policies lose their grandfathered status if insurers cancel coverage when a person becomes ill, impose lifetime limits on benefits, eliminate all benefits for a particular condition and reduce the cap for covered services each year, among other changes. (In fact, in November of 2010, the federal government loosened some of these standards.)
So yes, individuals can keep the plans they have if those plans remain largely the same. But individuals receiving cancellation notices will have a choice of enrolling in subsidized insurance in the exchanges and will probably end up paying less for more coverage. Those who don’t qualify for the tax credits will be paying more for comprehensive insurance that will be there for them when they become sick (and could actually end up spending less for health care since more services will now be covered). They will also no longer be part of a system in which the young and healthy are offered cheap insurance premiums because their sick neighbors are priced out or denied coverage. That, after all, is the whole point of reform.