New Mexico Mercury

As the Federal Exchange continues to frustrate all of us, we are also seeing other aspects of the ACA surface and become the fodder of attacks and misinformation.  While some benefits started early in 2010, other, more complex changes specifically related to the infrastructure of insurance reform start now that is causing further angst.  But then, as we see, it’s easy to blame everything on the ACA.

Losing your insurance

The issue that has caught fire is the problem for those with individual plans.  President Obama has repeatedly said that no one has to give up their plans if they don’t want to.  He recently apologized to the growing number people who were forced to give up their plan or pay significantly higher rates, or lost their plan because their plan was no longer offered.   What the President said is factually true, with the following caveat: you don’t have to give up your plan as long as your insurance company does not change your plan. In other words, the insurance company can continue to offer a plan if they choose to (which many chose not to) and if they choose not to raise their rates.  But then, there was a second unforeseen loophole.  If insurance companies reissue plans before December 31st of this year, they don’t have to be in compliance but they can still raise their rates.  I have seen one letter from a local insurance plan that in the first paragraph tells the policy holder that they had to increase rates because of the ACA, and in the second paragraph, that they don’t have to be in compliance with ACA requirements so the policy holder can purchase their plan without such noxious benefits as maternity services. So why, one wonders, did the premium on the plan increase so much?

Benefits and the common good

There has been a lot of argument about whether people should pay for benefits they know they will never use, e.g. maternity benefits. Building a new health coverage system is a little like improving safety features in cars or building highways.  You can’t pick only those pieces you decide you need and not pay for those you never use – e.g. seatbelts in the back seat if you are single or highways you think you will never drive on. These are for the common good and if we get really specific about it, people will want to wait to add coverage only after a serious diagnosis is made. That does not create a sustainable system.

Lest we forget

In the old system (I mean pre-ACA!) insurance plans built benefits to exclude the ones people needed the most – it was called exclusion for pre-existing conditions. Now we have a system that covers the generic needs for most people all of the time.   We need to celebrate this: all industrialized nations have these comprehensive benefits. We have to look at this process as an investment for the future – for a next generation of families and their children and grandchildren.