Help! Health Insurance Reform Question

[SweepPicker]

I am currently in a heated discussion with someone in another forum concerning whether or not you can or cannot keep your existing health insurance. Here is what I have been saying: yes of course you can keep your current insurance. Here is what was posted to make me feel that in fact, I may be wrong:

Section 102(a) of the Health Care Reform Bill HR3200 addresses the right to keep your current health care if you have an individual health insurance plan. If this is you, your plan will be "grandfathered." In plain English, if you pay for your insurance out of your own pocket rather than it being provided through your employer, then most likely, this clause applies to you. The few Americans who fall under this provision will be permitted to keep their current insurance coverage in tact and ungoverned by the new insurance requirements indefinitely. In addition, they will be permitted to add their dependents to the plan, so if you have a baby, your baby can have your coverage too. But, (isn't there always a but?) dependants will be the only new additions to these grandfathered coverages. After the legislation goes into effect, no one new can purchase this coverage. In addition, the insurance company will not be allowed to change the terms or conditions of the coverage, ever. This means they can not add nor eliminate coverage. If new technology or procedures emerge, you will not get them. If new drugs, even generic drugs, become available, you will not get them. On the up side, they also can not reduce your coverage. This also means they can not change any cost-sharing aspect of the plan including deductibles, coinsurance, co-payments, and similar charges but does not include premiums. If this clause applies to you, you must now ask yourself two questions: (1) Are you comfortable with having an insurance plan that in 20 years will only provide coverage for outdated procedures and medications that may not even be available for purchase any longer and pay higher premiums for it? and (2) Will your insurance provider continue to be willing to offer your coverage if they can not increase your co-pays or if more and more people answer 'no' to question number one and cancel their coverage?

For most people, your health insurance coverage comes from your employer. The politicians want you to think you can keep your current health insurance too. However, that is only a half truth, or perhaps I should say a temporary truth. Section 102(b) of the reform bill offers you a Grace Period. That is right, you do not get a grandfather clause, you get a Grace Period. Is not a Grace Period usually a time of forgiveness? I guess they are willing to forgive you for being naive enough to think you would be allowed to keep your health insurance, too. Employment-Based Health plans will be subject to a 5 year grace period after which time they must comply with the government benefit requirements. Mind you, those 5 years are maximum. Your plan could be changed immediately and you will not have a say in the matter.

if you don't like what you have or where what you have is going - you can't change it - or find a new plan - you will have NO choice.

if you read the bill and have a different interperation of what it says - by all means - please tell us what this is saying to you. i have provided you the link to the bill.

So? Is this person right? Is this what is stated in the bill?

[subterranean]

1. I read it, and that does seem to be what the bill says.

After the law goes into effect, insurance plans would have to meet minimum standards for affordable coverage, essential benefits and consumer protections. Individual plans that do not meet those standards would be grandfathered but would not be allowed to enroll new members other than dependents, nor change their terms and conditions. Employer plans would have a 5-year grace period. However, if the current plan already meets or exceeds those standards, then they would be considered qualified plans and would not be affected.

So yes, if your employer-sponsored plan is inferior to the "qualified plans," your employer would eventually have to upgrade. But employers change their insurance plans all the time, so I don't see why this would be a problem from the employees' point of view. Worst case scenario, they have to wait 5 years before getting a better health plan than they had before.

If you have a high-deductible individual plan with skimpy coverage now and you love it, you could still keep it. However, the limitations described above would apply.

[SweepPicker]

2. Thanks

I appreciate your reply and it looks like I was in the wrong. This does not apply to private insurance though does it? I have Care First and if I can get something as good at a cheaper cost I will certainly choose that.

[subterranean]

3. It would apply to private insurance.

The bill would mandate that virtually every American enroll in a qualified insurance plan, either public or private. As I said, even private plans would have to meet the government standards to be considered "qualified" plans.