President Barack Obama has repeated variations of the same message many times since first trying to sell the Affordable Care Act to the American public in 2009: "If you like your plan, you can keep it."
That isn't strictly true. Sure, the vast majority of people probably won't have to switch plans, since they get health insurance through their employers or the government. But it's a different story for many of the roughly 15 million people who purchase individual health insurance plans through the private market.
Of those people, two groups will be able to keep their coverage: Those with plans that offer ObamaCare's 10 essential benefits, and those with plans that have been made exempt, or "grandfathered." Plans can't be grandfathered if significant changes are made to them, such as if the copay climbs by more than $5. Those strict standards have resulted in only about 36 percent of people keeping their individual plans from 2010.
Ultimately, it will result in about 7 million people being forced to switch to more expensive plans. Republicans have been warning Americans about this scenario since 2009, and haven't been shy about reminding the press about it.
"For the mainstream media, this matters to them now because they feel like they were lied to — that’s why it’s caught on," Kirsten Kukowski, press secretary for the Republican National Committee, told Politico. "The White House made it out like we were the ones crying wolf, now it turns out they’re the ones who were wrong."
At best, the president was, as FactCheck.org put it, "oversimplifying and overpromising" on ObamaCare when he told people they could keep their plans. At worst, he was lying to the American people.
In the end, however, forcing people to switch plans is probably a good thing. Pre-ObamaCare individual health plans often skimped on — or even excluded altogether — some pretty basic things, including prescription drug coverage, mental health services, maternity care, and preventive services. ObamaCare also stops insurers from putting limits on annual and lifetime spending.
In other words: No wonder those old plans were so cheap.
The biggest issue is hospital visits. In 2011, the United States led the developed world in hospital charges, with the average stay costing $15,734. Many of the pre-ObamaCare individual plans "shouldn't even be called insurance coverage, because their coverage is too sparse to insure against financial ruin," writes The Washington Post's Sarah Kliff.
TIME's Kate Pickert backs up that assertion with a few disconcerting figures: In 2007, 60 percent of personal bankruptcies were related to medical bills. And about three quarters of those cases involved people who already had health insurance — just really crummy insurance.
And while Republicans might sound outraged over the president's broken promise, they "repeatedly endorsed proposals that would take insurance away from many more Americans," writes The New Republic's Jonathan Cohn. ObamaCare will at least force people into better plans:
Some people will pay more for these policies, some will pay less, but everybody will be getting coverage that includes an array of "essential" benefits, limits out-of-pocket spending, and can never be taken away or limited because the policyholder gets sick. In other words, everybody ends up with comprehensive, stable insurance. It may not be the policy he or she has today. But the vast majority of people with non-group market don’t keep the same policy for more than two years anyway. [New Republic]
Of course, conservatives would argue that it's not the government's role to force consumers to buy anything, even if it's better for them. But it's hard to argue that the bare-bones plans of old did anything more than provide peace of mind.
If Americans can't sign onto HealthCare.gov and get affordable replacements for their previous plans — not to mention some helpful tax credits — this is all moot. But while the president didn't help himself by glossing over the truth, Americans might eventually be glad they were dropped from their old plans.
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