To many experts and casual observers, the disastrous rollout of the Affordable Care Act has been frustrating but not all that surprising. The program is massive, President Obama often seems uninterested in details and little about this legislation has gone smoothly.
What few people expected, though, was that Obama’s repeated assurances that those who liked their current coverage could keep it were false, at least in some cases.
Over and over, Obama delivered variations on this quote, from April 2, 2010: “If Americans like their doctor, they will keep their doctor. And if you like your insurance plan, you will keep it.” It turns out there was an asterisk.
What Obama should have said, but didn’t, was that Americans could keep their health insurance if their policy met new standards for completeness.
Those standards include “10 essential benefits” detailed on www.healthcare.gov: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
The point, Obama said in Boston last week, is not only to cover the uninsured, but to improve coverage for the underinsured. And, indeed, the list of essential services deals with basic matters of health. They are appropriate on any health insurance plan. There are no elective cosmetic surgery riders on this plan.
But that’s not what Obama repeatedly told Americans they were getting and, as a result of that asterisk, some 137,000 Western New Yorkers are expected to receive letters informing them their insurance will be canceled on their anniversary date.
That’s shocking to those people and deceitful to everyone else. Those affected include those enrolled in the state’s Healthy NY program, which targets lower-income sole proprietors and people who work at smaller companies, many of whose plans do not provide prescription drug coverage.
To be fair, there are asterisks on the asterisk. Many of those people will qualify for subsidies that will lower the cost of the new health plans they are required to buy under the Affordable Care Act. Indeed, across the country, millions of people could receive subsidies that will pay the entire monthly cost of some of the plans available, although they tend to come with – another asterisk – the highest out-of-pocket expenses for doctor visits, hospitalizations and other benefits.
That’s fine, and the subject is suitable for a legitimate debate, as was the entire Affordable Care Act. What is intolerable is for Obama to have sold this plan to Americans on the grounds that no one would lose insurance they wanted to keep, only to have the rug pulled out from underneath them just as the main part of the law was to take effect.
As disastrous as the rollout of the plan has been, mistakes happen. Deceit is something else.