Obama, some Marylanders grapple with dropped insurance plans

November 06, 2013|By Meredith Cohn, The Baltimore Sun

Raymond Liu remembers President Barack Obama's promise that people would be able to keep their insurance if they liked it. He liked his, but he won't be able to keep it.

As Obama continues his campaign to win over Americans skeptical of the Affordable Care Act, the ranks of critics are growing, swollen by people such as Liu who are losing their existing health insurance because it does not comply with the law.

Liu is one of 73,000 Marylanders insured by nine insurance companies who will not be able to keep their policies because they were not grandfathered under the new health law. Only policies created before March 23, 2010, when the health law passed, can be grandfathered, according to the law.

Liu, 35, a self-employed Fulton resident, said he is healthy and not a big user of health care. He and his wife had a simple policy that suited their needs and cost about $300 a month, he said. After exploring new plans from CareFirst BlueCross BlueShield and on the state's new exchange for the uninsured, he learned that a similar policy might cost closer to $500 a month.

"This type of low-premium plan that provides for cheap preventive visits to the doctor is what I have always sought after," he said. "But they are no longer available under the so-called Affordable Care Act. The new plans are basically penalizing frugal, healthy lifestyle-seeking individuals such as myself and forcing us to fork over higher premiums for plans with higher deductibles and coverages that we don't need or want."

Around the country, many people like Liu are getting letters explaining that their plans will no longer be offered because they do not offer the minimum benefits required by the health law. The Maryland Insurance Administration said consumers should receive 90 days' notice if their plans are being discontinued, then they can look for new coverage from their insurers or on the state's health care exchange. Users say the exchange is still experiencing technical difficulties.

The law's supporters say these people will get more comprehensive policies with guaranteed benefits and protections — some that they might not have known they were living without — such as prescription drug coverage, no lifetime limits and no-cost preventive care.

But since they also include such benefits as maternity care, some critics say they can make the plans more costly for people who don't need or want those benefits.

One insurer, Aetna Inc., won't be signing people up for new policies because it is no longer allowed to offer such insurance in Maryland since it is not participating in the state's exchange. The company, which acquired Coventry Health Care earlier this year, said it won't renew 12,622 policies next year. A spokesman said those policies probably would not have met the minimum coverage requirements.

Aetna advised customers losing coverage to go to the exchange or to another insurance carrier to find a policy that meets their needs.

"Unquestionably, what they will get now will offer better coverage," said Dr. Peter Beilenson, who runs Evergreen Health Cooperative Inc., a nonprofit health insurance provider with plans on the exchange. "For some, the plans may be more expensive, but for others, such as those with a pre-existing condition, it may be less because their pre-existing conditions can no longer be considered."

Evergreen plans to send a flier Monday to people who might be looking for new policies, specifically including those who may have lost their coverage, Beilenson said.

He said he believes that this group is largely middle income or higher and that many might not be eligible for subsidies. They might be self-employed people who want a plan that has low premiums, high deductibles and not a lot of benefits, but offers protection in case of a catastrophic illness or accident.

Under the federal health care law, insurers can no longer consider factors such as gender or a new illness, which sometimes caused rates on the market for individuals to jump at higher rates than those offered to big businesses, said Carolyn A. Quattrocki, executive director of the Governor's Office of Health Care Reform.

In the past, people lost these individual policies because they could not afford them or were dropped after they got sick. Other consumers discovered when they had an illness or accident that they did not have the coverage they thought.

"Important consumer protections are now in place," she said. "New plans won't have hidden gaps in coverage that consumers may not even have been aware of."

It is unclear how many people across the country are losing their policies now. About 14 million to 18 million people have coverage on the individual market, said David Hogberg, a senior fellow for health care policy at the conservative National Center for Public Policy Research.

He said surveys show at least half the policies on the individual market do not meet the law's requirements.

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