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Monday, July 14, 2014
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Published: Thursday, 10/31/2013

GUEST EDITORIAL

Those ‘lost’ health plans

WASHINGTON POST

President Obama famously claimed that Americans who liked their insurance plans would be able to keep them under health-care reform. That’s not completely true, nor is it the only example of the Obama Administration failing to prepare the public for the Affordable Care Act’s phase-in. And it was one of the only things Republicans at a House Ways and Means Committee hearing this week wanted to talk about.

Some Americans are getting ominous-sounding letters about their health-care coverage. Insurance provider Florida Blue is canceling 300,000 bare-bones insurance plans that aren’t up to the Affordable Care Act’s standards. Customers can shift to better-quality — but more expensive — plans.

Unsurprisingly, reporters have found some unhappy customers. Conservatives charge that this is just another example of why the law is a lemon, forcing people onto plans they don’t want. But despite what the President may have said, this news should not have come as a shock. Nor is it evidence that the law is a failure.

Obamacare is rooted in the notion that all Americans should have access to a defined catalog of health-care benefits. They should not have to pay outrageous amounts of money to get that coverage.

The law means to accomplish that goal by mandating that everyone who is not on government-run programs such as Medicaid pay into the private insurance system. It sets standards for what health-care insurance must cover.

Plans must include prescription drug, mental health, maternity, preventive care, and other basic coverage. They must take care of at least 60 percent of patients’ health expenses.

The vast majority of Americans, most of whom get health insurance from their employers, won’t see much change. But a significant number — a study looking at 2010 figures said half — of customers who now buy insurance on their own don’t have plans of that quality.

Some old plans won’t be touched, because the law grandfathers them into the system. Some people who must shift to different packages might pay little more, or even less, than they do now.

The law places new limits on how much insurance companies can mark up plans for old and sick people. The government will help most people in the individual market pay for coverage.

But some people — no one seems to know how many, exactly — will end up paying more for insurance next year. They make too much to qualify for government subsidies, they are young, their previous coverage was shoddy, or, probably, a combination of the above.

Although some people might pay more than they did before, they and many others will also get more. Among other things, they will be less financially vulnerable when they get sick — in some cases dramatically less.

Their new plans will also put taxpayers at less risk of having to cover big medical bills when under-insured patients unexpectedly fall ill. That goes for people who now decline to buy insurance, but who will have to next year.

Reform still might not sound like a great deal to people who are young, feel healthy, and don’t want to pay for coverage. Yet having lots of healthy people paying into the new system on its terms will limit their financial risk.

Their participation also will allow others who have been priced out of the health-insurance market — those with serious pre-existing conditions, for example — to obtain good coverage. They deserve compassion too.

None of this is an outrage. It’s the predictable result of a defensible policy choice embedded in the reform.



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