Mimsy Were the Borogoves

Editorials: Where I rant to the wall about politics. And sometimes the wall rants back.

If you like your health insurance, you can go screw yourself

Jerry Stratton, September 15, 2014

If you like your health plan…

I’ve been expecting this letter ever since I signed up for private health insurance under the wire last December. President Obama and the Senate refuse to work with the House and Republicans to allow people to keep their insurance plans as promised. The president issues his edicts outside of the legislative process, and the Senate refuses to hear any fixes. This means that, no, I don’t get to keep my plan if I like it. Unless the exchanges have changed considerably since I looked at them last year, it also means my insurance premiums are going to nearly double—assuming I don’t decide just to take the tax penalty.

New Affordable Care Act (ACA) changes are here, but you can keep your Aetna health plan through December 31, 2014

In 2013 we told you that you’d need to move to an ACA-compliant plan when your current policy ended in 2014. We’ve since extended your policy. This allows you to stay in your current plan through December 31, 2014.

This is nice, but not that nice. Without the extension, my current plan goes through December 15, 2014. I deliberately moved to Texas in mid-December last year in order to get in under the ACA wire and have good health insurance for as long as possible before the ACA mess kicked in. But Obama wants to get even with me.

The letter continues:

Good news! There’s nothing you need to do until the 2015 Open Enrollment period begins.

Key points to note

  • Your monthly payment will stay the same.
  • Your deductible, out-of-pocket costs, and benefit limits remain the same and will not reset.
  • If you have previously received a Summary of Benefits and Coverage (SBC), it lists the benefits available through December 31, 2014.

On reading this, I thought, even though I had been expecting this letter, that somehow insurance companies were allowed to continue existing policies indefinitely and I hadn’t heard about it! Then I realized, on reading the next paragraph, that this applied only to the 15-day extension.

While your current plan is available through December 31, 2014, it cannot be renewed. All new policies must be ACA-compliant for the calendar year 2015. Open Enrollment for 2015 will run from November 15, 2014 to February 15, 2015. Before your policy ends, you will get information about plan options available to you.

That is, my monthly payment will not remain the same, nor will my deductible.

I am so not looking forward to that. When I decided I needed to fast-forward my plans to move to Texas last year, part of my decision was based on looking into the “ACA-compliant” plan options available to me. My current plan costs me $223 per month, which is outrageous. The nearest equivalent I could find, a Silver plan with a higher deductible, was $413.21 with the subsidy.1

Back in November of last year when I looked at what the ACA was going to mean for me, I zeroed in on a plan from Aetna that was outside of the ACA. It provided for a $1,750 deductible and I would pay 30% after the deductible up to $10,750. This would (and has) cost me $223 a month.

The closest equivalent I could find on the exchange was a plan with a $3,500 deductible, for which I would pay 20% after the deductible up to $6,350. And this would cost me $413.21 to 429.76 per month depending on what subsidy I qualified for. That would have been $2,282.52 more for the year. What will it cost this year? No idea. And it looks like they’re not telling me until November 15—after the elections.

You might say, wait, there’s a transitional policy fix to let people continue their existing insurance plans into 2017.

Not for me. I moved to another state in December 2013, and under our fucked up health insurance system policies are forbidden from being portable. I purchased a new plan starting December 15.

For reasons that are as confusing as the ACA, that plan is not eligible for keeping. Is it because it was after October 1, 2013?

Which policies are eligible to be restored?

Non-grandfathered policies in the individual and small group markets that were (1) in effect as of October 1, 2013, and (2) have received or would otherwise receive a cancelation or termination notice from the issuer. No new sales of these exempted policies are allowed.

My policy wasn’t in effect in October of last year. It didn’t start until December 15. I couldn’t keep my older policy because policies aren’t portable between states. And the White House hates me.

Or is it because it renews in December?

CMS further stated that, under the transitional policy, non-grandfathered health insurance coverage in the individual or small group market that is renewed for a policy year starting between January 1, 2014 and October 1, 2014 will not be considered to be out of compliance with certain market reforms if certain specific conditions are met.

Or is it because it’s a post-March 23, 2010 plan?

Grandfathered plans are those that were in existence on March 23, 2010 and haven’t been changed in ways that substantially cut benefits or increase costs for consumers. Insurers must notify consumers with these policies that they have a grandfathered plan.

Individual grandfathered plans can’t newly enroll people after March 23, 2010 and have that new enrollment be considered a grandfathered policy. But insurance companies can continue to offer the grandfathered plans to people who were enrolled before that date.

I received the notice a few weeks ago. It took me this long to rant about it because I prefer to understand what I’m ranting about. I still don’t understand this. As far as I can tell, President Obama’s vaunted grandfathering excludes policies started over four years ago. That doesn’t make any sort of sense. I suspect that part of the purpose of this law was to be so nonsensical that no one could understand it enough to complain about it.

Repeal it. Replace it. With something that makes sense as insurance. At least replace it with something that makes sense to non-politicians.

In response to Why we must not ration health care: Rationing health care means fewer cures.

October 14, 2014: Most Open and Transparent Lies Ever

Here is something I knew but didn’t remember: last year, the exchange prices were all out on October 1. This year the administration has chosen specifically to delay listing them, over a month, until after the election.

There are multiple meanings of transparent. And open, for that matter. When we were promised the most open and transparent administration ever, what we were promised were open disregard and transparent lies.

October 2, 2014: Only four-year-old policies grandfathered

Since October is Health Literacy Month, Aetna posted to Facebook asking “What confuses you?” about health insurance.

Since grandfathering definitely confuses me, I asked “Which policies are grandfathered and which are canceled by the ACA (and why)?” To their credit, they responded privately after asking for my insurance information.

Grandfathered members are only those that had active coverage before March 23, 2010. Anyone after that is considered non-grandfathered and would be subject to any changes mandated by the federal government due to ACA changes. If you have any additional questions please let us know.

So my final guess in the parent post is correct: only policies that are over four years old are going to be grandfathered past 2014. Anyone who purchased health insurance after March 23, 2010, cannot “keep their health insurance if they like it.”

  1. Calculating the subsidy is pretty much impossible when you know you’re going to go through some life changes over the next year or work for yourself. You have to know how much you’re going to make. If you don’t know how much you’re going to make, you don’t know how much the subsidy is.

    The whole system perpetuates the assumption that everyone has standard jobs, that is part of what was broken about the system in the first place.

  1. <- Dark bureaucracy
  2. Strangling health ->