How many health plans are "substandard"? 98 percent.


Because of a regulation designed to make nearly every plan rapidly lose grandfather status with every minor, routine change, millions of Americans have received letters informing them their plans have been canceled.  Many of them are unable to even get through the first steps of to see what their options there are, and others who are able to see their options are finding they have to pay more and may lose their doctors.

It is therefore a stone-cold fact the famous Obama promise from his June 15, 2009 speech to the American Medical Association (and repeatedly constantly since) has been broken:

“I know that there are millions of Americans who are content with their health care coverage -- they like their plan and, most importantly, they value their relationship with their doctor. They trust you. And that means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. (Applause.) If you like your health care plan, you'll be able to keep your health care plan, period. (Applause.) No one will take it away, no matter what.

Now, as those plans are being taken away, the White House and its shifty, dishonest media apologists have decided to denigrate Americans for liking their plans.

Exhibit A is the New York Times, which claims Obama “clearly misspoke” (over 25 times?) when he said you could keep your plan.  Their absurd headline? “Insurance Policies Not Worth Keeping.” All those millions of Americans just didn’t know any better.

How many plans are “substandard”?  Nearly all of them.

Millions of Americans are being told their plans are “lousy” or “crummy” because they are indeed, in a hyper-literal sense of the word, “substandard.”

Meaning they fail to meet the new standard for so-called Essential Health Benefits required of all plans in the individual and small-group markets when they lose grandfather status. This is the "standard," in brief:

This “standard” excluded nearly every plan in the individual market.

According to HealthPocket: “The data shows that there will be a near complete transformation of the individual and family health insurance market starting in 2014. Less than 2% of the existing health plans in the individual market today provide all the Essential Health Benefits required under the Affordable Care Act (ACA).”

Even the best of the best plans are being canceled in the individual market. Bob Laszewski, a top industry analyst, described his cancelation:

“I have been in this business for 40 years. I know junk health insurance when I see it and I know ‘Cadillac’ health insurance when I see it. Right now I have ‘Cadillac’ health insurance… The new plan would have a deductible $500 higher than the one I now have and a lot more if I go "out-of-network" inside the rest of the Blue Cross national network… And, wait all you people telling me rate shock does not exist, the new far more restricted plan costs 66% more than our current monthly premium.”

Not in the individual market?  Scott Conover did an extensive analysis on Forbes showing that there are also changes in the small-group market – where only five percent of plans offered required pediatric dental check-ups – and the large-group market.  He found that overall 129 million Americans will no longer have the health plan they had, including millions whose previous employer coverage will be outright dropped.

Gallblader cancer survivor Edie Littlefield Sundby has lost her plan that affordably covered all her cancer doctors and treatments. She wrote:

“You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so.

"…if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive—but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are…

"Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.”

The exchange plan wouldn't include her cancer doctors, but it would include maternity care and pediatric dental coverage and the rest of the now “standard” benefits – and that, according to Obama and the New York Times, makes her old “substandard” plan “not worth keeping.”

Now that’s lousy.