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NEW YORK TIMES


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When insurers drop policies: 3 stories

By Katie Thomas and Reed Abelson

New York Times

POSTED:



Charles Nance, Dean Wright and Julie Tyrrell are getting dropped — forced out of their existing health insurance plans — and landing smack in the middle of the uproar over President Barack Obama's health care law.

One expects to pay more. One expects to pay less. And one is just trying to figure it all out.

Each, in a different way, represents the relatively small part of America that the Obama administration did not talk about while campaigning for the Affordable Care Act: people who have health insurance that they like, but who will be unable to keep it under the law.

Now that new insurance marketplaces are opening, insurance companies are canceling millions of individual plans that fail to meet minimum standards. The dropped plans have become the political talking point of the moment — and, according to many Republicans, a symbol of the president's flawed ambitions.

Obama says that people will be better off in the long run with more robust coverage.

Yet the individual stories add up to a more complicated tale.

Nance, who did not like the president's plan to begin with, is angry.

He and his wife recently received a notice informing them that they could no longer keep their existing plan. Their insurance company offered an alternative that would cost twice as much.

"I don't think it's fair at all," said Nance, 57, a home inspector in suburban St. Louis.

Wright received a similar notice. But to his surprise, he will pay less by going through a state insurance exchange.

"It's a pretty good deal," said Wright, 63, a retired editor who lives in Birch Bay, Wash.

He said he will save about $100 a month, although his new plan will not cover out-of-network care.

And like many, Tyrrell is still trying to navigate the new landscape. Her existing plan will be dropped next year, she said, and her insurance company is raising prices by nearly 18 percent.

But she is unsure if she qualifies for federal subsidies because she has had trouble logging on to the problem-plagued government website, HealthCare.gov.

"There's so little information now," said Tyrrell, 54, a freelance writer in Phoenix.

The Affordable Care Act was signed into law by Obama in 2010. Since then he has assured Americans: "If you like your insurance plan you will keep it. No one will be able to take that away from you. It hasn't happened yet. It won't happen in the future."

But it is happening. It is unclear how many of the estimated 10 million to 12 million people who have individual insurance plans, as opposed to the vast majority who have insurance through their employers, might see their plans discontinued.

Individual plans are typically renewed annually and, even before the law, such plans were usually subject to changes in rates or coverage. Discontinuing plans affect a small minority of Americans, and some people will be grandfathered in.

Those in plans that have remained essentially unchanged since the law's passage can keep their coverage even if it does not meet the new standards, which include coverage for things like prescription drugs, maternity care and even pediatric dental care.

But because of the transitory nature of the market — individual insurance often serves as a bridge between jobs, or as a stopgap until government programs like Medicare or Medicaid kick in — many customers have changed plans or bought new coverage since the law was passed.

Insurance executives are frustrated. They say they want to keep as many customers as they can and are reluctant to turn away business. And they want to sell as many new policies as they can that comply with the law.

"We're not terminating their coverage," said Jon Urbanek, a senior executive at Florida Blue.

Many other insurance executives are reluctant to speak publicly, given the politics and public attention. Privately, many say that technical problems with the federal website have made people anxious about switching plans.

"They are not able to piece together a complete story right now, and that's adding to the confusion," one executive said.

Some insurers are offering to renew existing coverage before 2014. But some people must find an alternative. And some insurers are telling their existing customers about the plans that most closely resemble their current coverage, providing examples of plans that cost about the same or have similar features.

Supporters of the law are quick to note that the individual insurance market was an unforgiving place, favoring the healthy with reasonable rates while excluding older people or those with existing medical conditions. Plans must now offer more comprehensive coverage, and insurers must take all comers. Insurers must also charge everyone, healthy or otherwise, the same rates.

Still, many people were surprised by how the law could affect them.

Some said they felt betrayed, given that the president pledged that people could keep their insurance plans.

Nance was surprised that the new law would affect his family, because they had been paying for their own insurance for 11 years. His plan carries a deductible of $3,000 and a premium of about $500 a month. He said that he and his wife were in good health and that their coverage had met their needs.

Nance learned in September that his existing plan would end Dec. 31 because it did not comply with the new law. His insurer, Anthem BlueCross BlueShield, offered a replacement plan that would cost nearly twice as much and come with an annual deductible of close to $12,000.

"It's not affordable, and it's not better than what I had in any way, shape or form," Nance said.

He said he does not qualify for federal subsidies and has had difficulty signing onto the online marketplace to evaluate his options. For now, he has purchased a one-year plan through United Healthcare that is similar in price and features to his existing plan.

In Arizona, Tyrrell is struggling to figure out her options. For years she dealt with annual rate increases and the fear that her coverage would be canceled.

"It's a frightening situation," Tyrrell said.

She recently learned that she had rheumatoid arthritis, and when that happened, she said, "I thought, I have lost every bit of bargaining that I possibly had."

Tyrrell is not sure what she will do, but, despite the problems, she generally supports the law.

"We have to start somewhere," she said.






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nodaddynotthebelt wrote:
I am sure that there are a lot of arguments on both sides of the spectrum but I believe that this healthcare overhaul is much needed in this country. Many of us have health insurance and take it for granted that when we need medical care we will have the means to get it. But for many of our citizens, there is no such thing as health care because they cannot afford the monthly costs of insurance premiums. When we have many citizens that are stricken by health conditions that they cannot receive help for we have a problem. Our country will go out of its way to assist countries with their problems such as subsidizing their military or to help feed them but when it comes to helping our own people we are so blind. We spend billions to help defend other countries but we cannot even spare half that to help our own. Those that cannot get help for their health conditions will then become a greater burden on our people as many end up unable to work and pay taxes. It is amazing how polarizing this issue is. I have even heard one commentator on a news outlet that we should delay Obamacare for a year because it is "hurting the very people that it is supposed to help." How is delaying for a year much needed medical assistance to those who need medical attention but cannot afford insurance premiums? Delaying it for another year can mean the death of many who simply cannot get the medical help they need because they cannot afford insurance. What many fail to realize that we even give medical insurance to immigrants for free. If we can assist immigrants, why can't we assist those who have been born, raised and lived in our own state? To me, they should get priority over immigrants. Many of them are tax paying citizens who just don't make enough to pay for the high premiums. It seems to me that some politicians are being influenced by big business (health insurance companies) who do not want to offer their service to the masses and want to keep the status quo. They see it as cutting into their bottom line. They want to continue to charge as high a rate as possible with as little service as possible. Yes, there is a problem with the website that handles the offering of health care but that will be fixed in due time. It is also amazing how this distraction is being used by news outlets to say justify their arguments against Obamacare. I even heard one news outlet asking viewers to send in their "horror" stories regarding Obamacare. Actually, I am not surprised at this as these news outlets are owned by big business moguls and run by rich executives who use it to further their agenda. As for me, I am willing to pay more in premiums if that means that the less fortunate can be blessed with coverage. I would rather that my tax dollars be used to help my fellow US citizens rather than line some other country's pockets through military subsidies. One reporter asked a citizen of another country how they can afford trains and beautiful landscapes and he responded by saying that the US pays for their military.
on November 1,2013 | 10:43AM
FWS wrote:
Oh, we need to help the unfortunate who can’t afford their own healthcare. Sniff, sniff. The truth of the matter is that in a free society, some people will fail. And it’s been my experience that most of those who fail (at least in the US); do so because of their own poor choices. Do drugs, drop out of school, do some crime, do some jail time, eat Twinkies till you weigh 450 pounds, and you probably won’t be a success in life. Sorry. It’s not my fault. It’s yours! And it’s not the job of the government to make life idiot proof. Obamacare is socialism, plain and simple. It picks the pockets of the employed in order to support the others through unearned insurance subsidies. This giveaway will eventually swell to enormous proportions—who doesn’t like free money; and we will all have to pay for it. Every time some liberal mainstream media reporter talks about some loser ‘qualifying for government insurance subsidies’ remember where that money came from—your pocket.
on November 1,2013 | 03:30PM
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