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“When In Doubt, Go Shopping”: The Affordable Care Act Puts People, Not Insurers, First

It’s pretty straightforward: A major reason we have 50 million uninsured people in the United States is that insurance companies do not see individuals as a profitable market.

The recent uproar over canceled health insurance plans not only highlights the insurance industry’s out-of-hand dismissal of this market, but also reinforces why there is a need for the new health reforms under the Affordable Care Act .

Consumers have reason to be angry but they should be angry at the insurers, not the health care law. Connecticut’s Insurance Commissioner, Thomas B. Leonardi, announced Monday that of the approximate 27,000 insurance policy cancellation notices which have gone out only 9,000 of them were because plans were not in compliance with the health care law. The new law forbids insurers to deny or drop coverage when people get sick or have a pre-existing condition such as hypertension, diabetes or obesity. Consumers will gain those protections in 2014 whether they buy through the insurance exchange called Access Health CT or on their own.

Mr. Leonardi’s comments highlight the fact that it has been a customary practice of insurers to send their policyholders notifications that a particular plan will no longer be available or there’s been a change in benefits. Only one-third of the policies being canceled in Connecticut were plans that did not have protection under the law’s grandfather clause and did not meet the benefit standards or the consumer protections required by the law. The other two-thirds were discontinued as part of the insurance companies’ business-as-usual practices.

Historically, the health insurance industry has made its fortune by denying coverage to sick people, decreasing benefits and jacking up prices. Insurers do not see the individual market as profitable unless they continue to shift risk onto consumers through high deductible plans and unless they can raise rates on their customers as they age and develop health problems to the point they can no longer afford health insurance. That’s why they’re getting out. The Affordable Care Act is stopping this bait and switch approach.

Understandably, the cancellation notices came as a jolt for policyholders, especially because the reasons behind them were not made clear. Furthermore, insurers failed to do the right thing and inform their policyholders that other coverage options are now available to them under the new health care law.

Fortunately for consumers though, President Barack Obama‘s decision to give insurance companies another year to continue their substandard health plans carried the proviso that they must inform their customers of the new coverage opportunities under the health care law.

It’s too bad the commotion over the cancellations happened to coincide with the rocky rollout of the new health insurance exchange website. But consumers would do well to keep their eyes on the big picture, beyond the political grandstanding and partisan bickering. Websites can be fixed. Health care reform is about improving the quality of coverage benefits and offering more choice and affordability through the health insurance exchanges. That’s what Connecticut is trying to do.

Friday’s announcement by Gov. Dannel P. Malloy that the state would not extend poor quality policies through 2014 re-emphasizes Connecticut’s commitment to making sure its residents have access to plans that will provide quality comprehensive care. The state also announced that it was pushing back the date people had to sign up by for coverage that begins Jan. 1. Now residents have until Dec. 22, giving them an additional week to weigh the options on Access Health CT, the state’s health insurance exchange, and to find a plan that fits their families’ needs.

According to Access Health CT, in the first month, more than 300,000 Connecticut consumers checked out their options on the Website, almost 40,000 calls have been answered through the call center and more than 13,000 Connecticut residents are now enrolled.

Clearly, consumers here are getting the message: When in doubt, go shopping.


By: Frances G. Padilla, President of Universal Health Care Foundation of Connecticut, Op-Ed Columnist, The Hartford Courant, November 22, 2013

November 25, 2013 Posted by | Affordable Care Act, Health Insurance Companies | , , , , , , | Leave a comment


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