Fact Check: If you like your plan, if you like your doctor

Everyone by now knows this famous quote from Obama, the lie of the century.

However, is it a lie? I'm here to deliver a gut punch to the theory.

The Affordable Care was signed into law on March 23, 2010 with the promise that if you liked your current plan you could keep it. Since then, most people are no longer under their old plan and the statement is routinely put out as a lie by Obama. However, notice that key word? Maybe you missed it. "Most"

If you had a plan that was in place when the ACA was passed you were absolutely allowed to keep it. (as long as the insurance company still sells insurance clearly) In fact, many people do still have their plans under two provisions of the ACA:

Grandfathered
This is the most direct version of "If you like your plan..." Basically if you had a plan that was in force when ACA was passed and you've made no changes to it, you are still allowed to have it to this day without being forced to comply with ACA guidelines and there is no penalty for that. It is true in the individual space and the employer sponsored insurance space. Simple rule: had a plan you liked, made NO changes, keep your plan. No problem.

Grandmothered
This is a little trickier to understand. Basically after ACA went into law, a lot of companies at their renewals made changes to their plans but not to ACA plans. (ACA plans wouldn't come into effect for a few years after the law was actually passed) Even though they were told "If you make changes you will lose your current granfathered status" they still made the changes to save money. So what the government did (Under Obama) was create a process called "transitional relief" that allowed those plans who made changes AFTER 2010 (so no longer "like your plan, keep it" folks) This process allowed you to keep even this plan that took advantage of some of the ACA benefits and was saving you money while still being technically a non-ACA plan. This transitional relief has been continued every year since it was first established even though it was supposed to sunset a few years ago now. The Obama administration extended it every year.

So, with two robust provisions to allow you to keep your plan, why do so many people say they lost the plans they loved?

Coverage through an employer
Sometime after the 2010 law was passed, your employer made changes to the plan to save money. Sometime after 2012 when the last transitional relief plans were sold, your employer VOLUNTARILY switched to ACA plans because of either cost savings or to get the better benefits. The ACA didn't force you off of your plan, your employer did. There are still MANY employer plans that are either grandfathered or grandmothered today. If you work for a large employer you are probably a self funded plan and you are exempt from most of the ACA mandates to begin with.

Individual Coverage
This is the one where most people get upset. You purchased coverage for yourself/family through a broker or online and you loved your old plan. You miss your old plan. So who took it away? In most cases, you did. After ACA was passed the insurance company offered you a renewal that included the option to continue your grandfathered plan or switch to an ACA plan. Right out of the gates the ACA plans looked like better benefits for same price because of the new total out of pocket feature, the free preventive care, etc. If you were someone who wasn't in perfect shape and health and still approved for an old plan you were probably paying a high rate penalty and the ACA offered you price reduction. Regardless, in the majority of cases, the reason you don't have THAT plan any more is because you voluntarily chose to jump to ACA. It's also true that in the small window between 2010 and 2012 before ACA plans took over, most insurance companies allowed you to buy a plan that they then kept through transitional relief rules as well. (United Healthcare for example)

Now, it's not always true that you got rid of the plan yourself. If you had a grandfathered or grandmothered individual plan with United Healthcare, you lost it on January 1 this year by no choice of your own when United decided they no longer wanted to be in the individual marketplace. However, before you go beating up the ACA for that, here's an interesting tidbit. Prior to ACA, United Healthcare, through their arm Golden Rule, was barely a player in the individual marketplace. They started selling plans BIG TIME after 2010 because they saw a market. So chances are (in most states anyway) that if you had a United plan that was cancelled January 1 this year as an individual you didn't get it until after ACA was passed anyway.

This year (July) Humana did the same thing, cancelling all individual plans. They were bigger players in some states, Texas being one of them.

So, long story short:
If you liked your plan and didn't get to keep your plan, in the VAST majority of cases it's not because the ACA took it away from you, it is because either the company you worked for OR you yourself chose to give up that plan for cost savings or benefit enhancement somewhere along the way.

 

I'm not sure how to respond bobrek lol.

 

You don't understand what happened. The legislation didn't make those plans go away. Plenty of people still have those plans. You go all around Houston and you will find tons of companies that still have grandfathered or grandmothered plans. Lots of people who don't have them have only their employer to blame for making plan changes because in fact, they didn't like their plan.

 

If you have the same plan today you had in 2010 you are likely paying less than someone who has shopped around every year. Those 2010 plans are priced independently instead of through community rating so if you still have it, you probably have a good deal.

 

Yep. The old grandfathered plans, each person or company would get a rate increase that included market trends PLUS their own personal trend. So if you were healthy you might get a small rate increase, or none at all outside of the industry factor. Blue Cross was known to give negative renewals. If you are not grandfathered and instead on ACA priced plan (individuals and small businesses) you are rated under community rating so your personal experience doesn't factor in.