Monday, December 2, 2013

Capable of perjury

[Those who are capable of tyranny are capable of perjury to sustain it. - Lysander Spooner (of whom I had never heard but who turns out to be a remarkably interesting man)]

Here’s what President Obama said on November 14, 2013, when he announced that his Administration would not prosecute health insurance companies who continued to sell plans already in effect, even if they did not meet the ObamaCare requirements or the grandfathering requirements:

Already people who have plans that pre-date the Affordable Care Act can keep those plans if they haven’t changed. That was already in the law. That’s what’s called a grandfather clause that was included in the law. Today we’re going to extend that principle both to people whose plans have changed since the law too [sic] effect and to people who bought plans since the law took effect.

So state insurance commissioners still have the power to decide what plans can and can’t be sold in their states, but the bottom line is insurers can extend current plans that would otherwise be cancelled into 2014. And Americans whose plans have been cancelled can choose to re-enroll in the same kind of plan. [snip]

And — and so what we want to do is to be able to say to these folks, you know what, the Affordable Care Act is not going to be the reason why insurers have to cancel your plan. Now, what folks may find is the insurance companies may still come back and say, we want to charge you 20 percent more than we did last year, or we’re not going to cover prescription drugs now. But that will — that’s in the nature of the market that existed earlier.

On that same date, a letter from the Centers for Medicare and Medicaid Services clarified that the President’s announcement did not cover all of 2014:

... health insurance coverage in the individual or small group market that is renewed for a policy year starting between January 1, 2014, and October 1, 2014, and associated group health plans of small businesses, will not be considered to be out of compliance with the market reforms specified below under the conditions specified below.

At that point, the “conditions specified below” were that the policy be in effect as of October 1, 2013, and that the insurance company send a notice explaining how the policy being renewed did not conform to ObamaCare standards and that the policy holder has other options for coverage.

The letter also lists the parts of ObamaCare with which the insurance companies are permitted to not comply. It is now clear that either there are some significant portions of ObamaCare that were not included in that list, or that the Administration has changed the rules again. Either way, the President’s November 14 statement has been revealed to be untrue.

The New Jersey Department of Banking and Insurance has given health insurance companies the option of continuing cancelled health care plans, thus taking the President up on his offer. However, the November 26 press release announcing this decision cautions (emphasis mine):

“Despite the President’s recent announcement of a fix claiming that individuals will be able to keep their existing coverage, the fact is that many plans cannot be renewed in their current form and face selective enforcement by the federal government,” Commissioner Kobylowski said. “However, while restrictive federal parameters exist, we will cooperate with health insurers that choose to renew these plans.”

Further guidance provided as recently as this week by the federal government makes clear that even if an individual wants to keep their existing coverage in New Jersey, certain provisions will still be altered in order to make each plan consistent with federal mandates. Some of these potential changes include:

- In the individual market, plans that were supposed to be fixed by the President’s recent announcement will still have to eliminate the annual limits; 
- In the small employer market, services that are now covered under an annual cap will have to be revised to remove the cap; and 
- Continuing plans will still be subject to federal Obamacare fees and taxes for 2014.

Because of these changes, despite what the President and the Obama administration has recently claimed, it is anticipated that health insurance costs will increase for New Jersey consumers. 

The most popular plan in the New Jersey individual market is the Basic and Essential Plan, which covers more than 109,000 consumers and currently includes annual limits as a means to keep the premium affordable. Obamacare’s elimination of the annual limits will devastate this plan, and rates may require adjusting to cover the cost of additional requirements.

In response to the Department’s press release, Horizon Blue Cross Blue Shield of New Jersey issued a statement on November 27 (emphasis again mine):

Horizon Blue Cross Blue Shield of New Jersey is evaluating the Department of Banking and Insurance’s decision to allow health insurers the option to continue cancelled health care plans. Given the federal requirements to modify current products, we are assessing the impact to our members. Our initial sense is that this decision may still provide some relief for our small employer customers.

The statement from New Jersey’s Department of Banking and Insurance makes it clear that most New Jersey residents in the individual market will not be able to renew their plans in their current form after December 31, 2013. In particular, the requirement that Basic and Essential and Basic and Essential Plus plans have to be modified to meet Affordable Care Act requirements, essentially means Horizon Blue Cross Blue Shield of New Jersey would have to create new plans that would cost substantially more. We do not consider that a viable option for our individual members.

Horizon Blue Cross Blue Shield of New Jersey is evaluating the operational and financial impact of offering the option of renewing current products to our small employer customers and individual customers, who have products other than Basic and Essential and Basic and Essential Plus. It is important to note that more than 70 percent of consumers in the individual market have the Basic and Essential or Basic and Essential Plus plans.

What was it Obama said again?

And — and so what we want to do is to be able to say to these folks, you know what, the Affordable Care Act is not going to be the reason why insurers have to cancel your plan.

You can say it all you want. Doesn't make it true.

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