TONY WILSON: Health care reform means some will lose their health plans

Tony Wilson

Tony Wilson

Well, my letter finally showed up. No, not the one from Publisher’s Clearinghouse announcing that I may already be a winner. The letter was from Blue Cross Blue Shield announcing that I was, in fact, a loser.

At least I will be, come Jan. 1.

Like a growing number of Americans, our health insurance plan is being canceled, and we must find other coverage.

I know. I remember the emphatic speeches, too.

Here’s what President Obama said to the American Medical Association in June 2009:

“That means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”

And then in Portland, Oregon in April 2010:

“And if you like your insurance plan, you will keep it. No one will be able to take that away from you. It hasn’t happened yet. It won’t happen in the future.”

Well, the future is now, and we are losing our plan because it doesn’t meet the requirements established under the Affordable Care Act, which is turning out to be more oxymoronic every day.

Beginning in January, small groups (those with less than 50 employees) cannot offer plans except in certain limited situations with a deductible of more than $2,000 per person and $4,000 for a family.

Also, plans — per the law — cannot exceed an out-of-pocket maximum of $6,350 for an individual. We have a $10,000 deductible catastrophic plan.

I know many people in Washington, D.C., don’t understand how math works, so let me break it down: since $10,000 is greater than $6,350 our plan is going the way of the dinosaurs.

Our plan also offers a low $25 copay for primary care physician visits and low copays for generic and certain brand name drugs. The optional plan we are considering does not offer copays.

I like my plan. I want to keep my plan.

But as The Rolling Stones sing, “You can’t always get what you want.”

I saw an interview recently with Dr. Ezekiel Emanuel, who was described as one of the architects of the health care reform law. He initially blamed the big, bad insurance companies for cancelling all these policies.

I’m not saying that insurance companies are not big and bad at times. They certainly can be, and in my line of work I’ve had to deal with them when they were acting big and bad. (I’ve also seen them do the right thing in situations when they easily could have gone the big, bad route.)

However, in our case — and the case of millions of others across the country — this plan cancellation is not the fault of the big, bad insurance company. BCBS is cancelling our plan because they must comply with the parameters of the Affordable Care Act — the president’s signature legislation.

Thankfully, the reporter knew enough about the law to know that insurance companies are being forced to cancel these plans because of the law, and she pressed Emanuel on this point and noted that many of the new plan offerings are more expensive than what individuals and families were paying prior to the cancellations.

Dr. Emanuel finally moved off the blame game to the narrative that we are hearing spun now: “Well, it may be more expensive than what you were paying, but it’s a better plan.”

Not every plan being canceled is a subpar plan. Strong plans that people have purchased of their own free will in the free market because those particular plans met their individual needs or family’s situation are being canceled.

Better by your definition or mine? Better because instead of paying a $25 office visit copay we will be paying the full $100-plus cost of the average office visit? Better because we get to pay the full cost of any prescriptions we may need instead of low copays for those prescriptions?

Or, better because you say it’s better…and because that fits your narrative?

Have these people no shame? They’re certainly dancing so fast these days that they seem to have moves better than Jagger.

Questions or comments? Feel free to e-mail me at twilson@nfp.com.