Herald-Leader Editorial

Health care shakeup worth it: Insurers providing better coverage

November 6, 2013 

President Barack Obama should just swallow his pride and admit he was wrong when he repeatedly reassured Americans that if they liked their health insurance they could keep it.

Granted, it must be frustrating for the president.

Many of the people who are losing their current plans — including 280,000 Kentuckians — will never know how much better off they will be under new plans required by Obama's reforms, even if they have to pay more for them.

Eighty percent of Americans are insured by their employers or the government and don't have to worry about shopping for a new plan because of the Affordable Care Act.

About 15 percent have no health insurance for a variety of reasons, including cost and being shut out by pre-existing conditions, obstacles the law removes.

The remaining 6 percent must brave the individual market where until now buying coverage has been something of a crapshoot.

Imagine dutifully paying monthly premiums only to discover that when you need your health insurance it won't pay for the care you need and falls far short of protecting you from bankruptcy.

That's the fix in which medical catastrophes have landed too many holders of individual insurance plans. When health insurance fails to pay, the costs are shifted onto other people, just as when someone is uninsured.

Under the Affordable Care Act, insurers no longer can impose annual or lifetime limits on how much they'll pay. They must cover preventive care without co-pays and offer certain basic services.

And by 2015 they will have to limit individual out-of-pocket costs to $6,350. The cap on out-of-pocket costs was supposed to take effect next year, but insurers were granted more time to adjust.

That's a better deal than discovering you've run out of coverage just when you need it most.

The government isn't forcing insurance companies to eliminate plans that were grandfathered in by the 2010 law.

But it's only logical that insurers would end plans that don't meet the new standards because they can't sell them to new customers.

The president acknowledged as much under reporters' questions when he was pushing the law but kept reassuring people they could keep their plans nonetheless.

The truth is the Affordable Care Act is disrupting the individual insurance market, and that's a good thing because it needed to change.

MIT economist Jonathan Gruber, who advised Obama and Massachusetts Gov. Mitt Romney on that state's version of the Affordable Care Act, told The New Yorker that 97 percent of Americans are either left alone or are clear winners under the new law, while 3 percent are "arguably losers," meaning they will have to pay more for additional coverage they might never need.

Individuals and small businesses shopping for insurance on Kynect and the other new exchanges should be vigilant about the provider networks they can access, what level of coverage they're getting for their money and how much they could end up paying out of their own pockets.

The cheapest plan might not be the best deal.

But their chances of finding health insurance that will be there when they need it have gone up considerably thanks to the disruption.

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