well, not, *you*, but the guy behind you maybe?
from that right wing rag NYT: Small Firms May Not Keep Current Health Plans After White House Decision
don't know about you, but i'm growing weary of paying double what i was 2 yrs ago for what amounts to half the coverage. it sucks now, and it's only going to get worse - much worse - unless i want to join the ranks of tri-care & other fed'l emp plans.
from that right wing rag NYT: Small Firms May Not Keep Current Health Plans After White House Decision
simply brilliant in it's predictability. who's cozying up to big business *now*? [rhetorical question]Although President Obama and many Democrats promised during the health care reform debate that if you like your health plan, you can keep it, the health insurance plans that are now offered by small businesses probably will not survive the transition to a regulated marketplace. The Obama administration acknowledged this on Monday, when it proposed regulations for determining what insurance plans can remain exempt from market reforms. And while participants in those plans will probably be grateful for it, business owners may be less sanguine about the outcome.
Because so many people were evidently reluctant to trade the comfort of their current coverage for the promise of better coverage, the Patient Protection and Affordable Care Act enshrined Mr. Obamas promise in an ambiguous grandfather clause for existing insurance plans. For example, plans that were in effect on the day the law was enacted, March 23, 2010, will not have to adhere to the rules that define the minimum benefits in an insurance policy or specify an employers minimum contribution to premiums. They will not have to offer preventive care. Perhaps most surprising, they will be able to charge different premiums to different people based on health factors.
The provision alarmed some reform advocates, even though at the time nobody was certain how many people might be affected by it. Its unclear that companies will want to have the same insurance plan in 2014 that they have in 2010, the M.I.T. health economist Jonathan Gruber * told The Agenda in January. In part, though, whether a company will have the same plan will depend on what constitutes the same plan. Congress left that up to the administration, which offered up its formulation on Monday.
The Obama administration said it tried to strike a balance with the new regulations. The rule announced today preserves the ability of the American people to keep their current plan if they like it, declared a summary of the rule, while providing new benefits, by minimizing market disruption and putting us on a glide path toward the competitive, patient-centered market of the future.
In general, according to the summary, grandfathered plans will not lose that status when they make routine changes. These can include cost increases to deductibles and co-payments, so long as they are not significant. (However, the administrations definition of significant may differ from yours: medical inflation plus 15 percentage points.) A plan can also voluntarily add new benefits or new consumer protections without jeopardizing grandfather status.
On the other hand, Plans will lose their grandfathered status if they choose to make significant changes that reduce benefits or increase costs to consumers. It cannot, for example, raise the co-insurance percentage (the share of a medical bill that the patient pays). Nor can it reduce the employer premium contribution by more than 5 percent. (The actual cost of premiums, however, is not a factor in determining grandfather status at all.)
Most Americans get their insurance through companies with more than 100 employees, and the administration claims these people are not likely to see major changes to their policies. That may be fine for many of them, since big-company insurance plans have tended to adopt the protections the new law extends to everyone. However, not all do, and patients in subpar grandfathered plans will be left out. Here is where the premise of if you like it, you can keep it gets complicated: its not whether the employees like what they have. Its whether the employers do
don't know about you, but i'm growing weary of paying double what i was 2 yrs ago for what amounts to half the coverage. it sucks now, and it's only going to get worse - much worse - unless i want to join the ranks of tri-care & other fed'l emp plans.