Sebelius Explains 'If You Like Your Plan, You Can Keep It'

[DonViejo]

Source: TPM

DYLAN SCOTT – OCTOBER 30, 2013, 9:36 AM EDT
The first question Wednesday that House Republicans asked Health and Human Services Secretary Kathleen Sebelius about HealthCare.gov's troubled rollout focused on President Obama's promise: "If you like your health plan, you can keep it."

House Energy and Commerce Chair Fred Upton (R-MI) pressed Sebelius on why the president had made that statement, given recent reports of individual policies being dropped prior to 2014, which is when the law's major market reforms take effect.

"Mr. Chairman, there was no change," Sebelius said. "The regulation involving grandfathered plans, which applied to both the employer market and the individual market, indicated that if a plan was in effect in March of 2010, stayed in effect without unduly burdening the consumer with reducing benefits and adding on huge costs, that plan would stay in effect and never have to comply with any regulations of the Affordable Care Act."

"That's what the grandfather clause said. The individual market which affects about 12 million Americans, about 5 percent of the market. People move in and out. They often have coverage for less than a year. A third of them have coverage for about six months. And if a plan was in place in March of 2010 and again did not impose additional burdens on the consumer, they still have it. It's grandfathered in."

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Read more: http://talkingpointsmemo.com/livewire/sebelius-explains-if-you-like-your-plan-you-can-keep-it

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Sebelius On HealthCare.gov: 'I Apologize. I'm Accountable.'

DYLAN SCOTT – OCTOBER 30, 2013, 9:22 AM EDT

Health and Human Services Secretary Kathleen Sebelius formally apologized Wednesday for the flawed rollout of HealthCare.gov.

The launch "has been a miserably frustrating experience for way too many Americans," she said in her opening testimony to the House Energy and Commerce Committee. "You deserve better. I apologize. I'm accountable to you for fixing these problems."

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http://talkingpointsmemo.com/livewire/sebelius-on-healthcare-gov-i-apologize-i-m-accountable

[Pab Sungenis]

1. So, basically, it's what we said.

This is just one more move from the insurance companies to try and undermine the ACA.

[cheapdate]

2. My guess is that some crappy insurance plans

are being flushed out of the market.

The plans being offered for my locality in the federal marketplace exchange are almost astonishing. There are twenty-one "Gold" family PPO plans being offered and all but one of them is less expensive than my existing coverage. Several of these plans are less expensive by hundreds of dollars.

Hell, there are even three "Platinum" family PPO plans that are less expensive than my existing coverage.

[Heather MC]

4. Exactly

a lot of people have "cheap" plans but their deductible is 5k or more. Or as soon as they get sick their plan will drop them.

[ramapo]

5. So do many ACA plans

You get what you pay for in today's (pre-ACA) market. The cheap plans generally offer a limited scope of coverage with maximum payouts. From what I've seen, deductibles aren't too bad but you will be up the creek without a paddle if you have any kind of serious health problem.

Unfortunately, the insurance companies have taken advantage of every letter of the new law. Most bronze plans do not pay anything until you reach the deductible which is generally set at the maximum of $6500/$12000ish. Those with lower incomes can qualify for lower deductible plans along with the subsidy but the income limits are more stringent.

The insurance companies are the ones cancelling the grandfathered policies. I think in general people will get better policies for about the same premium but some will certainly pay more.

[Heather MC]

8. Single Payer is the only fix

I wish the Insurance Companies had nothing to do with Universal HealthCare.

I think it should be a simple system if you have a social security number and a date of birth, you should be able to go to any Dr. or hospital and get care period

[Roland99]

18. +infinity

[Grins]

11. Where?

"The plans being offered for my locality..."

Which is where...? Just curious.

[cheapdate]

21. I live in Murfreesboro, Tennessee.

This is deep red country. The fear of Islamic takeover of "our way of life" is a big issue here. The stridency of a candidate's opposition to immigrants and Muslims is a prerequisite for getting elected from here. The Tea Party swept every Democratic city, county, state, and national officeholder out of office in 2010. Murfreesboro has been in the news occasionally for a long-running dispute over the construction of an Islamic mosque and worship center.

The GOP controls all branches of our state government, with large majorities in both chambers of the General Assembly. They've passed 14 or more gun bills since 2010. They've passed education bills that prohibit the mention of homosexuality by educators ("Don't say gay" bill). They've prohibit colleges and universities that receive state support from having diversity and inclusion policies (we're looking at you, Vanderbilt University!). They've passed bills prohibiting municipalities from requiring contractors to have anti-discrimination policies in place in order to do business with the local government, etc., etc.

It's a mess.

[Kolesar]

19. Testimony yesterday revealed that some "insurance" did not even cover *hospitalization*

this was covered on NPR All Things Considered yesterday.
--
A toast to your good health! It's coffee this time :coffee:

[BlueStreak]

3. Her explanation is only halfway right

What she didn't say is that insurance companies were not compelled to continue those old policies. And when insurance companies see an opportunity to double prices with the government picking up the tab for that increase (and much more), they are deciding they like that a lot better than continuing in the fake non-insurance business.

That is where the "You can keep it" thing fell apart. I know the administration doesn't want to get into more of a pissing contest with the insurance companies than they already have, so what SIbelius said is basically what we get by way of answers.

[Igel]

33. Yes, and no.

"It's what we said" isn't complete.

"It's what we said, incorporating the entirety of the legal language of the bill, the regulations based upon this language, the implications that flow from this language and from the regulations, coupled with financial-based decisions that private insurers may make based upon projections or speculation about what regulations will be."

It's being disengenuous. The words meant precisely what they wanted them to mean, but not what a typical consumer or media watcher would have interpreted them to mean.

A couple of months ago a higher-up where I work decided that "dept. leaders had decided" some new policy at a meeting of dept. leaders. This was a surprise to the dept. leaders. When polled, of the two dozen dept. leaders two had, in fact, thought the policy better. So it was true that "dept. leaders decided"--but the standard interpretation is that all those had decided this and that it was some formal action of the meeting. Not just that a couple of people during the meeting had come to this decision, and then consulted with the higher-up after the meeting was over on how to implement it even though most present thought it was unworkable or a bad idea.

As soon as language is used in this way, it stops being a means of communication and becomes a mean of protecting power and gaining power. Those so using can never be trusted to mean what it sounds like they're saying because they know that they're trying to manipulate you and expect that you won't be able to figure it out. They also trust that a certain percentage of the population will rather like being manipulated.

1984 came of age in 2005, but it's held elected office for far longer.

[Psephos]

39. well said n/t

[thesquanderer]

6. I lost my plan

I had a plan with very good coverage BUT a $10k deductible. It also worked with a HSA so I could at least pay a good amount of any such medical expenses with untaxed income. (And yes, you can have a good plan with a high deductible. It had no caps, covered pretty much everything, had a large network of doctors, etc. If something catastrophic happened, I'd be in good shape. And luckily, I'm in a position where the $10k wouldn't break me. In the mean time, my monthly cost was low. It was a very sensible plan for me.)

Under ACA, my plan will cost at least double, if not triple. My deductible will be a lot lower, but I'll be paying thousands more in premiums, and my outlay before reaching the deductible will be higher because, with the HSA phasing out, I'll have to pay those bills with taxed income.

In neither case am I likely to spend anywhere near the deductible, as I am basically healthy and rarely see doctors. That is, the difference between a $2500 deductible and a $10k deductible doesn't much matter to me, as (barring a catastrophe) my medical bills are lower than $2500 anyway... now I'll just have to pay them with taxed income. And if I do end up with something catastrophic, once I factor in the higher premiums, I'm only a few thousand worse off on my current plan, and if I have a catastrophic illness, a few thousand will be the least of my problems.

The point is, I'm almost certainly going to be noticeably worse off under Obamacare.

Still, as a proper progressive, I accept that as the cost of a system that is better for most people.

[DhhD]

9. HSA-Health Savings Accounts are a Free Market Scam

October 20, 2013 Cross Post from the Texas Group. Texas Medical Association did not buy it from Texas Senator Canadian E.R. Cruz, Right Wing Extremist who spoke on the Senate Floor to try and stop the ACA-The Patient Protection and Affordable Care Act.

http://upload.democraticunderground.com/?com=view_post&forum=1078&pid=12858

In my opinion, that if you go to a hospital and ask an Insurance Billing Expert, You will find that your insurance plan with HSA, is a scam. And IRS Publications and Agents can help you understand the non-tax advantage of HSA (not any).

[thesquanderer]

12. It doesn't work that way.

Your key quote there, I believe, is:

"The scam in part is that there are tax free dollars to spend on your healthcare, that is until you go bankrupt"

There is no reason to go bankrupt with an HSA plan tied to insurance with a $10k deductible, unless $10k of bills would drive you into bankruptcy (not generally the case).

HSA *by itself* would be an absolutely terrible idea. But as a way to lower the effective cost of meeting some of your deductible (being able to do it with pre-tax instead of post-tax dollars), it is useful.

Like most financial arrangements, it's a matter of understanding what it is good for, and what it isn't.

[DhhD]

15. We both have our opinion. Using it by the end of every year would work. In my opionion,

very few people are ill on December 30 and well by Jan 1, when HSA resets.

[thesquanderer]

17. You are mixing up HSA and FSA

FSA (Flexible Savings Account) is "use it or lose it"

HSA (Health Savings Account) carries over year to year, that's what I have. (Had.)

http://healthsavingsaccountshsastoday.wordpress.com/2008/09/08/if-you-dont-use-your-hsa-do-you-lose-it/

[DhhD]

29. IRS-Who should have a HSA.

HSA will be allowed under the 2014 ACA Plans. What is new from 2013?

2013
http://www.irs.gov/pub/irs-pdf/p4942.pdf

[thesquanderer]

31. HSA is only permissible with a high deductible plan

My high deductible plan is being discontinued as of 12/31. My understanding is that Obamacare doesn't have the high deductible (HSA compliant) plans. So I guess the only way you can maintain HSA is if you already have it, on a plan that isn't going away.

[rgbecker]

22. Apparently, if you had this policy in 2010 you could continue it.

At least that is the thrust of this thread. I'm interested why you didn't just continue it.

[thesquanderer]

24. I didn't have it in 2010.

In 2010, I was covered by a company policy from a place I used to work.

Interestingly, I got a notice from my current insurer saying that they were discontinuing the plan as of 12/31/13 (so I must find an ACA alternative). It's possible that this plan simply didn't exist in 2010, I don't know.

[cheapdate]

23. I don't completely understand the dramatic state-by-state variances

in the price of insurance. Here in Tennessee you could get a similar plan (catastophic, high deductible, individual) to what you had for around $150 or less.

[thesquanderer]

25. Not so different

Yes, I'm playing a bit over $200 for that plan here in New York. The problem is that the plan is going away as of 12/31, and Obamacare offers nothing comparable.

In Tennessee, are such plans available under Obamacare? Or is it that there are existing plans that will continue to be available to those who have them?

[cheapdate]

27. According to Healthcare.gov there are "Bronze" and "Catastrophic" plans

offered on the federal exchange for Tennessee. The 17 plans available are mostly from BCBS (Blue Cross Blue Shield) and Humana and range in price from $113 to $204 (before any applicable subsidies) for an individual under age 50.

[thesquanderer]

32. There was no such plan offered to me on the New York state exchange

I don't know whether it's an issue with New York, or some other difference, like I'm not under 50. Or a web site foul up, for all I know! All I know is, I went through the process, it offered me a bunch of plans, and nothing like that.

Any New Yorkers here? Did you see any high deductible "catastrophic" plans in your offerings, in the $200-ish price range? (Before any subsidies.)

[Pterodactyl]

35. That really stinks. I hope you find a good replacement.

[Shemp Howard]

10. The key phrase is "additional burdens"

What does "additional burdens" mean?

If the insurance company doubles the cost of a policy, I would guess that's an additional burden. And so that policy would no longer be grandfathered.

But suppose the insurance company raises rates that are roughly in line with their increasing costs (inflation, etc.). Is that an additional burden?

Or suppose the insurance company eliminated some dental coverage, but keep everything else the same. Is that an additional burden?

And why should it even matter in the first place? Shouldn't the policy holder decide? Either pay the increased rates, or drop the plan and take an ACA policy.

I suspect that there is a lot of insurance company mischief involved here. And that mischief was enabled by the ACA law itself, perhaps inadvertently.

There has got to be a way to insure every American without all this confusion.

[1StrongBlackMan]

13. Thanks to an (apparently) bad bean burrito, last night ...

I have pleasure of sitting at home to watch the "oversight committee" questioning of Sebelius ... It is an absolute and complete waste of time.

[JoePhilly]

14. You have to enroll every year already. Which means every year, you could lose your

current plan if your employer or insurance company decides to "change" something.

The ACA does not cause this.

[Denise21]

16. Secretary Kathleen Sebelius

Secretary Kathleen Sebelius, I can't believe the crap that these GOP MTFRs' gave you they are all a--holes. Secretary Kathleen Sebelius, I am behind you 100%.

[kiranon]

26. It's more of the Republican war on women.

Do not believe the Congressmen would have been so disrespectful to a man. She couldn't get in an answer with so many of the Republicans who just fired off questions and had no interest in her answering them.

[RobinA]

20. I Guess

my read on the Obama statement was that if you like your plan, ACA will not force you to change plans. To me, the fact that your existing plan would have to continue to exist in order for you to keep it is implied. I have employer insurance, but I only keep plans that the employer continues to offer. I liked their former prescription plan better than the one I have now, but I can't keep what they don't offer.

That said and the web site aside, I do think the administration could have done a WAY better job of priming the pump on ACA pre-rollout. Hell, if there's one thing this country still does well it's hype, advertising and PR. There's got to be plenty of people around who can run a successful...let's say...campaign, who could lend a few pointers.

[ArizonaModerate]

28. Insurance Changes?

You know three times in the last eight years my employer has changed health insurance plans causing me to lose a PCP and forcing me to find new specialists. Changing insurance to save a buck is something companies have ALWAYS done. While I believe President Obama misspoke when he said "if you like your plan you can keep it" it certainly wasn't a "lie" as being portrayed by the Obama-obsessed Republicans in the House of Representatives.

Business as usual for corporate America not some "Obama-Conspiracy" to lie to us and take over our healthcare.

FYI - I work in a hospital and I'm thankful everyone will have coverage. Uncompensated care is bankrupting some hospitals and all it does is drive up the cost of care for everyone else. Theres a reason we spend twice as much on healthcare as any other industrialized nation yet have worse results and it isn't "big government"... it's GREED and PROFIT driven healthcare. Medicare for all!

ArizonaModerate

[gopiscrap]

30. Welcome to DU

[uppityperson]

34. Welcome to DU.

[quadrature]

36. Dump the Sickos!

this is what I don't like about the ACA.

suppose some Insurance Company(IC)
has a customer they want to get rid of.

solution--> offer, (or force) , a reduction in the co-pay.
Some years later,
the ACA allows the IC to drop the policy.
Result, get rid of them in Jan'14.

[PSPS]

37. It's those with individual policies that are getting screwed.

Based on my own experience and what I've heard from others, people with individual plans like me (self-employed) will pay at least double the premium under ACA.

[Shemp Howard]

38. Friends have told me the same thing. And they are very worried.

And no, it's not alright.

It is not alright that some people are losing insurance policies that they are happy with, policies that they have had for years.

It is not alright that some people cannot afford the replacement polices.

And it is NOT alright that any working person must suffer under the ACA. It is simply not defensible.

I don't know who is at fault here. Maybe the insurance companies, maybe the policy wonks who wrote the ACA, maybe Congress. Maybe all three.

But the President and Congress - both parties - need to put their pride aside. Amend the Affordable Care Act. Forget about the website for now. Fix the part of the law that is harming, not helping, people.

I hope that things work out for you, PSPS. Good luck.