Given several articles today, and in recent weeks, surrounding employers’ and insurers’ responses to the health care overhaul, it’s worth highlighting the numerous caveats being added retrospectively to candidate Obama’s promise that “You will not have to change plans.  if you have insurance now, nothing will change under the Obama plan – except that you will pay less.”  But now, nearly eight months after the law passed, that promise has been turned into “If you like your current plan…”

You Can Keep It—For One Year:  The New York Times this morning outlines how the Administration is waiving certain rules, including those for medical loss ratio requirements included in the law, in response to prior reports that McDonald’s and other employers may drop their existing limited benefit (aka “mini-med”) coverage without exemptions from the new regulations.  However, the guidance released by the Administration clearly indicates that “HHS intends to…determin[e] whether mini-med plans should be accorded similar treatment for the second and third years preceding 2014.”  In other words, while McDonald’s workers and other employees with mini-med plans may have received a one-year reprieve to keep their current coverage, they could very easily lose that coverage as soon as next year.

You Will Pay More:  The Times also notes this morning that “many companies are passing on to their workers most, if not all, of the higher costs” during open enrollment season this year: “Employers are increasingly asking their workers to pay more of the cost of coverage for their dependents, or to pay more of their share of a hospital stay or an emergency room visit.”  These cost-sharing increases are far from the $2,500 per family reduction in premiums and health costs that candidate Obama promised his health care plan would bring about.

You Get A Refund:  Several weeks ago, the Administration attempted to trumpet a USA Today story on premium refunds granted to some North Carolina Blue Cross policy-holders.  However, an article from Inside Health Policy noted that the refunds are being granted only because the Blue Cross policies will end in 2014 as a result of the health care law.  Insurers generally pre-fund a portion of claims costs expected over the lifetime of a policy (i.e., applicants pay more in Year 1 so they will pay less in Year 5 or Year 10).  But because the health law unexpectedly shortened the time horizon of some individual policies to end in 2014, the pre-funding mechanism Blue Cross had in place will no longer be needed, resulting in the refunds. 

Tough Luck:  Those who have insurance policies with Principal Financial Group, or Medicare Advantage policies with Harvard Pilgrim Health Care, are losing their coverage entirely.  The New York Times noted that Principal’s decision represents “another sign of upheaval emerging among insurers as the new federal health law starts to take effect,” while the Boston Globe noted Harvard Pilgrim’s decision “was prompted by a freeze in federal reimbursements” made in the health care law; as one executive put it, “We became concerned by the long-term viability of Medicare Advantage programs in general….We know that cuts in Medicare are being used to fund national health care reform.”

RPC Analyst Chris Jacobs