Yesterday, the rules governing health insurance in the brave new world of Obamacare were released, and even the cheerleaders at the NYT view them with a jaundiced eye:
In some respects, the rules appear to fall short of the sweeping commitments President Obama made while trying to reassure the public in the fight over health legislation.
Sweeping commitments such as ”If you like your health care plan, you’ll be able to keep your health care plan, period.” I guess, in the end, it all depends on what the definition of “keep” is:
The law provides a partial exemption for certain health plans in existence on March 23, when Mr. Obama signed the legislation. Under this provision, known as a grandfather clause, plans can lose the exemption if they make significant changes in deductibles, co-payments or benefits.
In other words, if you or your employer make some choice that our masters in DC deem inconsistent with “essential health benefits,” you don’t get to keep your plan after all. Ooops.
Under the rules, a health insurance plan can lose its exemption if it eliminates all benefits for a particular condition.
A health plan loses its exemption if an employer reduces its contribution so that its share of the total cost of coverage declines by more than 5 percentage points.
An employer would also lose its exempt status if it increased co-payments for doctor’s visits to $45, from $30 — a 50 percent increase — while medical inflation was 8 percent.
Some health plans require consumers to pay a percentage of the bill, rather than a fixed dollar amount. An insurer loses its special protection if it makes any increase in this percentage.
Some insurers cap the amount they will pay for covered services each year. If they want to retain their grandfathered status, they cannot reduce any annual dollar limit.
The above-listed changes could very well reduce coverage costs for employees, yet any of them would render that whole “you can keep your plan” promise null and void. Another day, another broken health care promise.
And the beat goes on.
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