The Mankato Free Press
---- — Here are two statements:
(1) The ACA does not require that you give up the insurance you have now.
(2) Insurance companies and employers will never be able to make any decisions that would affect the insurance coverage you have now.
President Obama said, “If you like your health plan, you can keep it.”
Those attacking the President for lying need to show that he clearly meant both (1) and (2). The evidence for (1) is clear, namely, the ACA’s grandfather clause. But the evidence that he meant (2) is non-existent. I would even say the claim that he was promising (2) is ridiculous. In context, Obama was talking about what government would do (or not do), not about what employers and insurance companies could do.
According to the Cigna Insurance website, “Plans remain grandfathered indefinitely unless companies:
Significantly reduce benefits
Increase costs to their employees, or
Reduce how much the employer pays toward benefits.”
There is another way the grandfather status disappears, namely, if employers or insurance companies decide to substitute new insurance plans for grandfathered ones — since new plans must conform to the new, required minimum standards of the ACA. As the Blue Cross website puts it, “Carriers [companies selling insurance] have the choice whether or not to continue grandfathered plans — a decision not to grandfather would mean that a plan had been modified to comply with all regulations applying to post-March 23, 2010 plans.”
If persons in the individual insurance market are receiving notices about these substitutions, this occurs because of the insurance company’s choice, not a governmental demand.
Since employers and insurance companies continually decide to make changes in insurance plans, the grandfathered plans probably will disappear over time. But the net result should be better health insurance coverage at a more affordable cost for the vast majority of people.
Can the President be accused of “bait and switch” tactics, since he knew about the likely disappearance of grandfathered plans over time?
First, in a classic bait and switch operation, the consumer gets fleeced for the benefit of the perpetrator. By contrast, the ACA works to provide affordable, better health care for consumers.
Secondly, all along, the president has faced a special problem with the ACA: Opponents are trying almost any dirty trick to destroy it. It’s not just House Republicans trying to defund the ACA by forcing the government shutdown and most of them voting to allow a debt default.
They’ve used misinformation to spread as much fear as possible: death panels will be killing grandma, Medicare benefits are being cut, it’s a government takeover of health care; it’s socialism; government bureaucrats will stand between you and your doctor; premiums will skyrocket; the government takeover will force you to lose the health insurance you have now; deficits will explode and bankrupt the country; you’ll lose your job or be cut back to part time status; the ACA’s unconstitutional; the individual mandate destroys freedom. They prey upon people’s frequent fear of change.
People need reassurance. That’s why President Obama made clear that the government was not forcing elimination of health plans people already had. But another reality has to be recognized: Generally, there’s no way of stopping change, although you can make it better or worse. Over recent decades, the changes in health care have made coverage and affordability worse for people not on Medicare, Medicaid, or VA coverage. Rather than let this trend of change continue, the ACA works to make coverage and affordability better. So the basic issue is change for the better vs. continuing change for the worse, not a bait and switch game.
Reality also requires careful thought about personal stories. For example, a 63-year old woman was upset because part of her premiums under the ACA would go for maternity coverage she doesn’t need. Is she equally upset that part of the premiums of a 30-year old would go for coverage of her osteoporosis, if she develops it?
What about the ACA requirement that women cannot be charged higher premiums because of their gender? Let’s remind ourselves of this basic insurance principle: Enough money is available for people who need it if there is a large enough pool of people facing a variety of risks, who pay premiums even though the risks may never materialize.
Government programs like everything else are seldom, if ever, perfect enough to benefit every single person coming under them. But that’s not sufficient reason to do away with government programs and everything else.
Ron Yezzi, now emeritus professor of philosophy at Minnesota State University, taught courses in social and political philosophy. He lives in Mankato.