"If you like your plan, you can keep your plan."
That famous phrase (a handy compilation here), used time and time again by President Obama in promoting the Affordable Care Act, has gone from a selling point for the administration, to a point for ridicule for the law's opponents. And the White House yesterday --for the first time-- admitted that for many people, that guarantee will not be the case because of regulations in Obamacare that make many present policies illegal, even if customers like them.
When the issue was brought up Monday by Fox's Ed Henry and NBC's Peter Alexander, White House spokesman Jay Carney attempted to dance around the issue, ultimately replied that there would be "winners and losers" under the plan but that President Obama was clear from the beginning Obamacare would raise the bar on insurance plans and some existing plans don't meet "those minimum standards."
We're likely to see a predictable script: The White House on the defensive while conservatives raise questions about the president's credibility.
But there's an important, moral and likely overlooked question here: If, under the Affordable Care Act, you actually lose your old health insurance plan, did you really have coverage to begin with?
Wait, you say: I thought the president said, "if you have a plan, you'll get to keep it." But we're clearly seeing that not only won't everyone get to keep their health care plan because insurers are dropping those plans, and new policies can come with serious sticker shock.
Florida Blue, a major health care provider in the sunshine state, is dropping the plans of 300,000 Floridians that aren't compatible with the higher standards mandated by Obamacare, including the GoBlue 91 limited liability plan of 56-year-old Dianna Barrette.
Barrette, profiled on CBS News Monday morning couldn't believe the letter from Florida Blue telling her that her old plan at $54 a month was being discontinued and she'd be offered a new, more expensive plan costing – ready? – $591 a month.
Why are people like Barrette losing their health care? Because the ACA requires every plan to provide 10 essential benefits, almost none of which Barrette's plan covers. According to the GoBlue summary, Barrette's plan:
- Pays up to a $50 discount on all in-network services. The patient pays the difference between that and the rate "negotiated" between Florida Blue and the provider, and there's no out-of-pocket maximum cap.
- Her plan discounted medicines, but didn't cover them. "Contraceptives and self-injectable drugs are not covered. GoBlue pays up to $5 or $15 per prescription, depending on the plan purchased."
- Doesn't cover maternity/pre-natal care or hospital visits.
By comparison, the new plan FloridaBlue is offering provides:
- A $6,250 cap on out-of-pocket expenses in-network
- Free preventative care/screenings and immunizations
- No charge or a $4 copay on some prescriptions
- Free eye exams and glasses for kids
How many of those 300,000 policyholders had plans like Barrette's? We don't know, but liability plans like the one she had are highly controversial, often leave policyholders more vulnerable to devastating medical bills than they may realize. For instance, Barrette's plan wouldn't have covered her if she was admitted to the hospital.
So what, you argue. Barrette may have a better plan, but her premium is 10 times higher, and she wants to know why she can't keep what she has now?
In plain truth, it's because Barrette's plan was probably a ripoff. Her "GoBlue" plan was so bad, she'd be better off not having an insurance plan at all.
If she was in a critical position and kept in the hospital, she'd be unable to pay her bill. She'd fall into that category known as "self-pay/no-pay," which means taxpayers and other policyholders would be saddled with the costs. Just like it was before Obamacare was passed.
And this is without even considering a conversation about federal subsidies Obamacare provides for people like Barrette (which is calculated based on salary, though her current plan targeted people making less that $50k annually).
In one way, you could argue that Barrette is a "taker" because her plan is so poor we'd have been forced to pay for her health care. At the same time, she's also being taken because this plan is so inadequate, someone sold her a bill of goods. What sort of insurance covers a maximum of $50 per day? It would be like having collision coverage that covered $50 maximum damage.
True, $54 a month isn't a lot, but that's $650 a year, and at 300,000 such policyholders, FloridaBlue was making $194 million a year for providing coverage that covered nothing.
Did the president lie? Did he not know this would happen? Definitely a fair question, a useful attack point for opponents. But the bigger question remains: If you're not covered, who pays for your health care? Should everyone be responsible enough to pay for their own health care, and if that coverage is inadequate and the cost of treatment gets passed on to you, is that right? Has this problem even been solved by Obamacare?