GOP's Obamacare gotchas...not so much.

The GOP hyped their  anti  ObamaCare crusade with some gotchas  recently .  One   is   “aha, the President lied” about Obamacare (ACA, Affordable Care Act) when he promised “if you like your insurance, you can keep it.” . The other is  “the web site does not work”.  Gotchas? Maybe not so much.

 When the President first made those promises in 2010, he was not lying.  If your  individually purchased policy   in 2010 when the law was passed  was the same now, you get to keep it if you want to.  However, in the small print, if there were any new policies  issued or changes after March 2010, you would have to either upgrade it to meet new standards or find another one.

The other gotcha is the federal  web site does not work, but most concede that it eventually  will. Remember, too, Colorado runs its own marketplace and site and it is working. As of October 25, Connect for Health Colorado saw 44,935 accounts created and 3,164 people enrolled, not including Medicaid enrollments. This even beats the first month’s experience of Massachusetts, after which ObamaCare was modeled.

,The individual insurance  issue may not be a big deal for most of us, but it is a big deal for those individuals affected. Some are understandably  livid.    An estimated 8 million of the 12 to 15 million  who had bought insurance individually got letters recently from their insurers dropping their insurance or raising their rates because the old policies did not meet the new standards required by ObamaCare. Those impacted are about 5%. The rest of us , over 200 million with Medicare, Medicaid, employer provided insurance,  are not.

What may be of consolation to many of  those who got the drop or premium increases notices, is that they  are not  left without insurance.  The new policies are comprehensive, unlike their old policies , called by some as “ Swiss cheese full of holes”  or “junk”, as Consumer Reports called most of  them in March.  An estimated 50% of those dropped  will qualify for subsidized premiums in the exchanges and  pay less and get a better policy for their money. The rest can   have access to the exchanges which function much like large group policies and could even offer  a better deal. Shop first in the exchanges to get a grip on the alternatives..

The  minimum provisions  now required to be included in all insurance policies are   ambulatory patient services ,emergency services, hospitalization ,maternity and newborn care, mental health and substance use services , prescription drugs, rehabilitative and habilitative services and devices ,laboratory services, preventive and annual checkups and cancer screenings, chronic disease management, and pediatric services, including oral and vision care. There are also consumer protections in the new standards,  such as forbidding caps on the amount of coverage, denial because of pre-existing conditions, dropping  coverage when you get sick or are in the middle of treatment, charging more for women, outrageous out of pocket co pays and deductibles, and  administrative costs exceeding 20% of the policy spent on actual services.

Those liking their old policies may  never need all of these basics  such as maternity and child coverage ,  and they  treasure their  right to  gamble they will never need others . Their  right to buy underinsurance is indeed trampled, but the Supreme Court upheld the individual mandate over other rights. All  need to be in the pool to make any of the advantages of  the law financially feasible, including covering women’s health needs without charging them more, which has been the case in the past.   Grandfathering in substandard policies may be one of the tweaks that could be considered  by Congress..The issue then becomes  the  impact on financing the  law’s implementation and how to make up the difference with a “pay for”.