This was always the weakest aspect of Obamacare: depending on private health insurers to play nice. They don't. They won't. Especially under ACA, consumers must remain savvy, well-informed and stick up for their rights.
Meanwhile, health insurance companies keep adjusting their earnings numbers for 2013 upward -- largely thanks to Obamacare. So don't cry for them -- or cry "socialism!" Please.
Anyhow, some customers have complained -- or more often, others have repeated complaints they heard from FOX or talk radio -- that they were satisfied with their individual insurance plan that was cancelled because their insurer declined to upgrade their plan to comply with Obamacare, or else insurers raised the price to comply.
Two responses here. First, individual health insurance policies typically last one year anyway, and then insurers raise prices and change conditions when offering renewal -- this was the way long before Obamacare. The HHH's grandfathering rule for Obamacare stipulated that, to be grandfathered, plans couldn't be changed after March 23, 2010, and prices could only rise with the medical rate of inflation. Pretty strict, admittedly.
So Obama should not have promised you could keep your current plan if you liked it -- because insurers have never let you keep your plan the way it was if you liked it. Insurers always raise prices and/or decrease coverage.
Over the past few decades, insurance costs have gone up while coverage has gone down. That was the trend before Obamacare. That was what Republicans such as John Boehner and Mitch McConnell preferred.
Now in 2013, and projected again in 2014, the rate of medical inflation is going down, a heartening reverse of a long-term trend.
Second, it's impossible to say for certain in every case, but I would bet that most of those people have not had a catastrophic event or even an ambulance ride under their current plan. Obamacare requires insurers to cover them in almost every instance to avoid medical bankruptcy, the #1 cause of personal bankruptcy in the U.S.
And let's face it: currently, if you're an individual consumer, the primary reason for having health insurance is to avoid unpayable, unexpected medical bills that could ruin you. It really is insurance in the same sense as earthquake or life insurance: it only saves you in the worst-case scenario; the rest of the time it seems like a nuisance.
I predict that when all the dust settles and the website starts working, most consumers will realize they're getting a better deal.
By Juan Williams
November 5, 2013 | FoxNews
Liar! Pinocchio! Deceiver!
With all the charges flying against President Obama in the on-going effort to stop ObamaCare it’s time for a reality check.
Having failed to kill the Affordable Care Act in Congress by shutting down the government the opposition is currently taking delight in charging the president will lying to the public when he said anyone who likes their current healthcare plan will be able to keep it under the new law.
It turns out that some people in the individual care market – about 5 percent of the overall insurance market -- are having their insurance policies cancelled.
It is estimated that half of those folks will get better coverage for a lower price. Some people will even get subsidies to help them pay the lower price.
But some people losing their current policies [and being offered better coverage] are going to have to pay a higher price. Taking crocodile tears to a new level, ObamaCare opponents are now rushing to their defense and calling the president a liar.
These critics include Republican politicians who did not vote for ObamaCare; these are Republican governors who refuse to set up exchanges to reach their own citizens; these are people oppose expanding Medicaid to help poor people getting better health care; these are people who have never put any proposal on the table as an alternative fix for the nation’s costly health care system that leaves tens of millions with inadequate medical coverage and tens of millions more totally uninsured.
The fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled this month, you should not be blaming President Obama or the Affordable Care Act.
You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care.
Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people.
The government did not “force” insurance companies to cancel their own substandard policies. The insurance companies chose to do that rather than do what is right and bring the policies up to code.
This would be like saying the government “forces” chemical companies to dispose of toxic waste safely rather than dumping it in the river.
Or the government “forces” people to drive with intact windshields and working brake lights.
How dare they “force” drivers to pay money to get those things fixed if they are broken?
One of the most popular and important provisions of the Affordable Care Act is setting basic minimum standards of medical insurance coverage. Here are some of those standards:
- Your insurance company is no longer allowed to cancel your policy if you get sick
- Your insurance company cannot deny you coverage or charge you more if you have a pre-existing health condition
- Your insurance company must allow you to keep your children on your plan until they turn 26 years old or get a job that provides health insurance.
- Your insurance company cannot impose lifetime caps on your health coverage.
- And perhaps most relevant to current discussion about insurance companies canceling substandard policies, your insurance company must cover what are called “essential health benefits.”
What are “essential health benefits?”
They are clearly defined on HealthCare.gov:
“Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.”
That’s right.
If you are rushed to the hospital in an ambulance, the ACA says your insurance company has to pay for the ambulance ride.
If your son or daughter has a bout with depression or suffers from panic attacks, the ACA says your insurance company needs to pay for their medicine and treatment from a mental health professional.
People should be angry that their insurance companies were not paying for these humane, common sense benefits all along.
It baffles me that people are directing their anger at the ACA which rights these terrible wrongs.
The Hartford Courant newspaper reports that the CEO of Aetna insurance made $36 million last year plus several millions more in stock options.
They also report that the CEO of Cigna cleared a cool $12.5 Million plus stock options.
The American health insurance industry is one of the most profitable in the history of the world. Before the ACA, they made money by finding any excuse, any loophole to deny coverage to the sickest and most vulnerable people in our society.
Rather than being vindictive and canceling policies under the pretext of ObamaCare, the insurance companies should be thanking their lucky stars that they do not have to contend with a public option or a single payer system. That is what the law allows in every other modern industrialized democracy.
No comments:
Post a Comment