Sunday, September 9, 2012

Does Obamacare let everyone keep their health insurance plan?

A friend of mine posted this on Facebook:

Got a long letter from my health insurance saying the Affordable Care Act is causing my health benefits to be significantly reduced and my premiums to increase. I'm sure I'm not the only one.

Dear Obama, that's fine, but don't call it the Affordable Care Act.
Here's Politifact on President Obama's claim that "[i]f you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance. This law will only make it more secure and more affordable." Politifact says:
[A] March 2012 study by the Congressional Budget Office, the nonpartisan number-crunching arm of Congress, projected that 3 million to 5 million fewer non-elderly people would obtain coverage through their employer each year from 2019 through 2022 than would have been the case before the law was passed. Including those with individually purchased policies enlarges that decline by an additional 1 million to 3 million Americans.

CBO’s estimate is broadly in line with a number of other independent estimates. . . .

In reality, Americans are not simply able to keep their insurance through thick and thin. Even before the law has taken effect, the rate of forced plan-switching among policyholders every year is substantial, and the CBO figures suggest that the law could increase that rate, at least modestly, even if Americans on balance benefit from the law’s provisions.
Politifact concludes: "We rate Obama’s claim Half True." That seems pretty generous.


Richard Lawrence Cohen said...

My insurance is the federal Pre-Existing Condition Insurance Plan -- the risk pool instituted by "Obamacare." I'm self-employed and pay all my own costs, and in the recession my income has declined. At my age and in my medical condition it would be impossible for me to obtain private insurance on an individual plan -- companies including Blue Cross and Humana have turned me down automatically on the basis of my initial application, without even sending it to underwriting for a decision, even before I knew all of the conditions is actually have. My state risk pool would cost twice as much as the federal risk pool, by law. Government risk pools sometimes have such small networks of providers that the quality of care is far from trustworthy, but in August the PCIP hooked up with a major insurer to provide a choice of providers that leads me to trust that the surgeries I will probably need in the future will come with an acceptable risk of killing or disabling me. The Affordable Health Care Act has very likely preserved me for an active future life and saved me from poverty due to expensive surgeries and ongoing treatments.

John Althouse Cohen said...

That is great to hear.

I've always been in favor of the Obamacare rule against pre-existing condition discrimination. So I was glad to hear Mitt Romney say on the last Meet the Press that he would keep this policy in place:

GREGORY: Well, let me ask you about a couple of specific areas. On healthcare, you say that you would rescind the president’s healthcare plan on day one. Does that mean that you’re prepared to say to Americans, young adults and those with pre-existing conditions, that they would no longer be guaranteed healthcare?

MR. ROMNEY: Well, of course not. I say we're going to replace Obamacare. And I'm replacing it with my own plan. And, you know, even in Massachusetts where I was governor, our plan there deals with pre-existing conditions and with young people. . . .

GREGORY: So you'd keep that part of the federal plan?

MR. ROMNEY: Well, I'm not getting rid of all of healthcare reform. Of course, there are a number of things that I like in healthcare reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage.

Another implicit point in what you're saying would seem to be that the U.S. system, where the government has long encouraged people to rely on their employer-provided health insurance, is bad for people like freelancers who don't have a continuous employer.

Speaking of the pre-existing condition rule, I do think it's worth considering how that policy goes along with the idea that Obamacare creates a "mandate" to buy health insurance. The mandate is really a tax on people who don't buy it — but the tax legally has to be lower than the cost of health insurance. Isn't it predictable that lots of young, healthy people (the kinds of people Obamacare is supposed to help) will decide not to buy health insurance, and pay (or dodge) the tax instead, knowing that whenever they really need, say, major surgery, they'll be able to buy affordable health insurance?