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Insurance Policies Not Worth Keeping


Posted: Nov 3, 2013

 

 
EDITORIAL

Insurance Policies Not Worth Keeping

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Congressional Republicans have stoked consumer fears and confusion with charges that the health care reform law is causing insurers to cancel existing policies and will force many people to pay substantially higher premiums next year for coverage they don’t want. That, they say, violates President Obama’s pledge that if you like the insurance you have, you can keep it.

Readers’ Comments

Mr. Obama clearly misspoke when he said that. By law, insurers cannot continue to sell policies that don’t provide the minimum benefits and consumer protections required as of next year. So they’ve sent cancellation notices to hundreds of thousands of people who hold these substandard policies. (At issue here are not the 149 million people covered by employer plans, but the 10 million to 12 million people who buy policies directly on the individual market.)

But insurers are not allowed to abandon enrollees. They must offer consumers options that do comply with the law, and they are scrambling to retain as many of their customers as possible with new policies that are almost certain to be more comprehensive than their old ones.

Indeed, in all the furor, people forget how terrible many of the soon-to-be-abandoned policies were. Some had deductibles as high as $10,000 or $25,000 and required large co-pays after that, and some didn’t cover hospital care.

This overblown controversy has also obscured the crux of what health care reform is trying to do, which is to guarantee that everyone can buy insurance without being turned away or charged exorbitant rates for pre-existing conditions and that everyone can receive benefits that really protect them against financial or medical disaster, not illusory benefits that prove inadequate when a crisis strikes.

Starting next year, all plans sold in this country will be required to provide 10 essential benefits, including some, like mental health and substance abuse treatment and maternity and newborn care, that are not now part of many policies. And premiums may well rise, in part because insurance companies must accept all applicants, not just the healthy.

Premiums are apt to come down for older patients and sicker patients with chronic illnesses. Premiums will likely go up for younger, healthier patients. Even so, analysts at the Kaiser Family Foundation believe that most people will actually pay less next year, because those with modest incomes will qualify for federal subsidies and many poor, uninsured people will be eligible for Medicaid.

Many higher-income people who won’t qualify for subsidies, however, will have to buy policies providing more benefits than they want. Maternity care for those who will not have children is one sore point. But that is one price of moving toward universal coverage with comprehensive benefits. And some of these higher-income people could suffer a catastrophic accident or illness that would previously have bankrupted them, but will now be paid for by insurance.

People under 30, who might balk at higher premiums, have another option. They can buy a catastrophic plan that provides all the essential benefits but keeps premiums low by making the beneficiaries bear a greater share of the cost. The hitch is that people who buy such plans are not eligible for federal subsidies, so many would probably be better off buying the cheapest plan available on the exchanges. Federal analysts estimated last week that, after subsidies, two-thirds of the uninsured young adults in 34 exchanges around the country could get coverage for less than $100 a month, and almost half could get it for less than $50 a month. That sounds like a bargain for comprehensive coverage.

Some conservative groups, eager to cripple the individual market by deterring enrollment, are urging consumers not to take out insurance and to instead pay the fine, which is cheaper than the cost of insurance but hardly negligible. For individuals, it starts at $95 or 1 percent of applicable yearly income in 2014, whichever is higher, and rises to $695 or 2.5 percent of applicable income in 2016. But why pay the penalty and get nothing when you can pay a reasonable fee and get a good policy?

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From the article: "This overblown controversy has also obscured - Good, fair, read

[ In Reply To ..]
They are referring to the GOP-induced hyperbole when they speak of 'overblown controversy'

I would encourage the ACA detractors to read the article 'carefully' - it clarifies some of the issues with the ACA, but anyone who thought this roll out would not have problems - even serious stumbling blocks does not understand that WITH SIGNIFICANT new policies in a country of this size there will be problems.

ACA may require retooling the law, or otherwise adjusting. But grown ups expect that - spoiled children looking for ANY WHISPER of a problem in order to torpedo the whole concept, do not!

No it absolutely is not a "good fair read." - Not illiterate (I'm a pub)

[ In Reply To ..]
Unfortunately, most of the policies that are being cancelled are not substandard. They are policies people have had for years, with affordable deductibles, and lower out of pocket costs. For many who don't need drug abuse counseling and maternity care, they cover their needs just fine. They don't need to replace it with a crap policy offered by Obama under the guise of being more comprehensive. Another line of BS. Learn to recognize it for what it is. Period.

You mean learn to believe as you do, - right?

[ In Reply To ..]
Can you substantiate your claim that "most of the policies that are being cancelled are not substandard. They are policies people have had for years, with affordable deductibles, and lower out of pocket costs. For many who don't need drug abuse counseling and maternity care, they cover their needs just fine" ??

I am really curious if you can substantiate the claim or if I should just regard it as uninformed opinion.

Thanks in advance!
This is not Huffpo, but Huffpo says 11 mil. - (substandard my arse_
[ In Reply To ..]
nm
When does auto-opposing Dems become wishing - ill on everyone? Cons SHOULD be glad to
[ In Reply To ..]
learn insurance companies are no longer being allowed to victimize their policyholders.

No one should be so meanly partisan as to turn all sour-faced on learning insurance companies are required to cover care for newborn babies.

Being relieved that Obamacare truly is designed to do its best for the American people as a whole is a mark of a good citizen, regardless of how one feels about government involvement.

FT
This is an article - By an insurance company, correct?
[ In Reply To ..]
There is in the article the quote, "Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees."

And here is an example of the extremely poor reporting on the ACA, especially by an insurance company, who should know better:

"Kris Malean, 56, lives outside Seattle, and has a health policy that costs $390 a month with a $2,500 deductible and a $10,000 in potential out-of-pocket costs for such things as doctor visits, drug costs or hospital care.

As a replacement, Regence BlueShield is offering her a plan for $79 more a month with a deductible twice as large as what she pays now, but which limits her potential out-of-pocket costs to $6,250 a year, including the deductible.

'My impression was …there would be a lot more choice, driving some of the rates down,' said Malean, who does not believe she is eligible for a subsidy."
_________
WHO DOES NOT BELIEVE SHE IS ELIGIBLE FOR A SUBSIDY? Come on, you're an insurance company. You have to know. Find out and tell her if she is eligible for a subsidy, and if she is not, tell US why not! Honestly, all this innuendo and implication is not reporting at all, and consider the source!

The insurance industry is trying to have it both ways - they want the right to still gouge as much as possible, they want to try to scare people, but not so it's too noticeable, just enough to get the crazy people out on Fox News talking about how horrible it is, and it's becoming apparent that these "reporters" are not doing any sort of in depth reporting at all, just putting these less than stellar mouthpieces on their shows to regurgitate what they have been feeding them for months.

The insurance companies also know the ACA is a potential windfall for them, but they are going to try to eke the last pathetic dollar out of the silly idiots who would rather not even check the exchanges but moan about how much their insurance is going up just because they want to believe Fox News.

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