Another family getting screwed by Obamacare

[edthecynic]

If that is true then why are the insurance companies canceling people's plans? If the law allows people to keep plans that don't meet ACA requirements why would the insurance companies be sending out letters by the hundreds of thousands for that very reason?

Already posted that! The insurance industry sees an opportunity to take advantage of people uninformed about the law. They claim that is Capitalism in action!!!

Special Investigation: How Insurers Are Hiding Obamacare Benefits From Customers

Across the country, insurance companies have sent misleading letters to consumers, trying to lock them into the companies' own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces -- which could lead to people like Donna spending thousands more for insurance than the law intended. In some cases, mentions of the marketplace in those letters are relegated to a mere footnote, which can be easily overlooked.

The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.

The insurance companies argue that it's simply capitalism at work.

Sorry, but you're article is obviously quite biased in favor of Obamacare. It's interesting that it mentions nothing about some specific provision of the ACA, this so called grandfathering of plans. It's even more interesting that no one in the administration is mentioning this. You would think Obama, or his press secretary or Sebilius or someone who is taking all this grilling would have just said 'Nope, we didn't lie. All old plans are grandfathered in and can be kept if so desired. It's the insurance companies trying to make more money.'

And as a business strategy the above doesn't even make sense. Cancel thousands of plans and hope those people decide to buy a more expensive one from you when you could have just let them keep paying for existing ones as normal? Sorry. That argument doesn't hold any water.

Gee, what a surprise....NOT!
You give the Right the facts and they claim the facts are biased!!!

And Carney, Sebelius and others have made that very point, only to be called liars for telling the truth. Any plan in effect before the ACA was passed, no matter how shitty or nonconforming it is, can be grandfathered by the insurance company.

Carney said, It’s insurers who are choosing to close plans, "the administration doesn’t step in" to force cancellations. Instead, "the insurer is making a decision to basically cancel the plan and reissue or offer the individual a new plan with different benefits or different costs."

Jarrett tweetedT it was a "fact" that "nothing in Obamacare forces people out of their health plans."

And here is the Grandfather Rule direct from Sebelius' HHS website, admit it, you've been lied to by the Right and you swallowed their lies without question!

U.S. Departments of Health and Human Services, Labor, and Treasury Issue Regulation on ?Grandfathered? Health Plans under the Affordable Care Act

“The Affordable Care Act gives American families more control over their health care by providing greater benefits, cost savings and protections,” said Secretary of Health and Human Services Kathleen Sebelius. “Today, with the announcement of the new ‘grandfather’ rule, we’re providing the market stability and flexibility to ensure that families and businesses can make the choices that work best for them.”

While the Affordable Care Act requires all health plans to provide important new benefits to consumers, under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The “grandfather rule” issued today makes it clear that these plans can continue to innovate and contain costs by allowing insurers and employers to make routine changes without losing grandfather status. Plans will lose their “grandfather” status if they choose to significantly cut benefits or increase out-of-pocket spending for consumers – and consumers in plans that make such changes will gain new consumer protections.

“The rule we are announcing today will allow employers to make routine and modest adjustments to co-payments, deductibles and employer contributions to their employees’ premiums without forfeiting grandfather status. This flexibility will encourage employers to continue offering health coverage to their employees and help to ensure coverage for all Americans,” said Secretary of Labor Hilda Solis.

 

[Wry Catcher]

It turns out that those crappy policies from bad apple insurers aren't crappy policies, and that the insurers aren't bad apples either. Does anyone think Obama will admit it.

The best part about this is how the reporter, who supports Obamacare, admitted they are getting screwed. In other words, it is already screened for the Obamazombies that insist that all these stories are lies.

The couple — Lee, 60, and JoEllen, 59 — have been paying $550 a month for their health coverage — a plan that offers solid coverage, not one of the skimpy plans Obama has criticized. But recently, Kaiser informed them the plan would be canceled at the end of the year because it did not meet the requirements of the Affordable Care Act. The couple would need to find another one. The cost would be around double what they pay now, but the benefits would be worse.
“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.
I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA. In many cases, it turns out, the consumers could have found cheaper coverage through the new health insurance marketplaces, or their plans weren’t very good to begin with. Some didn’t know they could qualify for subsidies that would lower their insurance premiums.
So I tried to find flaws in what Hammack told me. I couldn’t find any.

• The couple’s existing Kaiser plan was a good one.
• Their new options were indeed more expensive, and the benefits didn’t seem any better.
• They do not qualify for premium subsidies because they make more than four times the federal poverty level, though Hammack says not by much.

Hammack recalled his reaction when he and his wife received a letters from Kaiser in September informing him their coverage was being canceled. “I work downstairs and my wife had a clear look of shock on her face,” he said. “Our first reaction was clearly there’s got to be some mistake. This was before the exchanges opened up. We quickly calmed down. We were confident that this would all be straightened out. But it wasn’t.”

What is their biggest beef?

“We’re not changing our views because of this situation, but it hurt to hear Obama saying, just the other day, that if our plan has been dropped it’s because it wasn’t any good, and our costs would go up only slightly,” he said. “We’re gratified that the press is on the case, but frustrated that the stewards of the ACA don’t seem to have heard.”

Loyal Obama Supporters, Canceled by Obamacare - ProPublica

ya know what.... booohhoooo. I feel SO bad they have to pay more and their god lied to them.

i hope every single person who voted for obama gets screwed to the wall and fleeced for health care insurance right into bankruptcy. I truly hope they get the worst bottom of the barrel care and pay through the nose for it.

You do? I can't decide if your hope is simply nasty or evil. On reflection, such a desire makes the jump from callous conservative to something much worse than nasty. So, what or who made you evil?

 

[Bern80]

Already posted that! The insurance industry sees an opportunity to take advantage of people uninformed about the law. They claim that is Capitalism in action!!!

Special Investigation: How Insurers Are Hiding Obamacare Benefits From Customers

Across the country, insurance companies have sent misleading letters to consumers, trying to lock them into the companies' own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces -- which could lead to people like Donna spending thousands more for insurance than the law intended. In some cases, mentions of the marketplace in those letters are relegated to a mere footnote, which can be easily overlooked.

The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.

The insurance companies argue that it's simply capitalism at work.

Sorry, but you're article is obviously quite biased in favor of Obamacare. It's interesting that it mentions nothing about some specific provision of the ACA, this so called grandfathering of plans. It's even more interesting that no one in the administration is mentioning this. You would think Obama, or his press secretary or Sebilius or someone who is taking all this grilling would have just said 'Nope, we didn't lie. All old plans are grandfathered in and can be kept if so desired. It's the insurance companies trying to make more money.'

And as a business strategy the above doesn't even make sense. Cancel thousands of plans and hope those people decide to buy a more expensive one from you when you could have just let them keep paying for existing ones as normal? Sorry. That argument doesn't hold any water.

Gee, what a surprise....NOT!
You give the Right the facts and they claim the facts are biased!!!

And Carney, Sebelius and others have made that very point, only to be called liars for telling the truth. Any plan in effect before the ACA was passed, no matter how shitty or nonconforming it is, can be grandfathered by the insurance company.

Carney said, It’s insurers who are choosing to close plans, "the administration doesn’t step in" to force cancellations. Instead, "the insurer is making a decision to basically cancel the plan and reissue or offer the individual a new plan with different benefits or different costs."

Jarrett tweetedT it was a "fact" that "nothing in Obamacare forces people out of their health plans."

And here is the Grandfather Rule direct from Sebelius' HHS website, admit it, you've been lied to by the Right and you swallowed their lies without question!

U.S. Departments of Health and Human Services, Labor, and Treasury Issue Regulation on ?Grandfathered? Health Plans under the Affordable Care Act

“The Affordable Care Act gives American families more control over their health care by providing greater benefits, cost savings and protections,” said Secretary of Health and Human Services Kathleen Sebelius. “Today, with the announcement of the new ‘grandfather’ rule, we’re providing the market stability and flexibility to ensure that families and businesses can make the choices that work best for them.”

While the Affordable Care Act requires all health plans to provide important new benefits to consumers, under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The “grandfather rule” issued today makes it clear that these plans can continue to innovate and contain costs by allowing insurers and employers to make routine changes without losing grandfather status. Plans will lose their “grandfather” status if they choose to significantly cut benefits or increase out-of-pocket spending for consumers – and consumers in plans that make such changes will gain new consumer protections.

“The rule we are announcing today will allow employers to make routine and modest adjustments to co-payments, deductibles and employer contributions to their employees’ premiums without forfeiting grandfather status. This flexibility will encourage employers to continue offering health coverage to their employees and help to ensure coverage for all Americans,” said Secretary of Labor Hilda Solis.

Two problems with your quote; one remember all those exemptions that were handed out to various employers? That's what the above is in context to as you will notice it mentions nothing about the individual market. Only insurance provided through employers. The exemptions were granted because of the increased costs to the employers of these new plans.

2nd problem is even though it's still talking about just employer provided insurance it is still about as vague as it gets;

....requires all health plans to provide important new benefits....plans that existed before March 23, 2010 are exempt from some new requirements

Well which is it? Specifically what requirements are they exempt from? What about people who are happy with the plans that existed before that date? Obama made his statement about getting to keep your plan with ZERO qualification. There was no 'unless it was purchase before March 23, 2010.', in any of those speeches.' What constitutues a 'modest adjustment' in rates and/or deductibles? Did you consider that Obama's new requirements might render it impossible to make modest adjustments in price to those plans?

 

[edthecynic]

Sorry, but you're article is obviously quite biased in favor of Obamacare. It's interesting that it mentions nothing about some specific provision of the ACA, this so called grandfathering of plans. It's even more interesting that no one in the administration is mentioning this. You would think Obama, or his press secretary or Sebilius or someone who is taking all this grilling would have just said 'Nope, we didn't lie. All old plans are grandfathered in and can be kept if so desired. It's the insurance companies trying to make more money.'

And as a business strategy the above doesn't even make sense. Cancel thousands of plans and hope those people decide to buy a more expensive one from you when you could have just let them keep paying for existing ones as normal? Sorry. That argument doesn't hold any water.

Gee, what a surprise....NOT!
You give the Right the facts and they claim the facts are biased!!!

And Carney, Sebelius and others have made that very point, only to be called liars for telling the truth. Any plan in effect before the ACA was passed, no matter how shitty or nonconforming it is, can be grandfathered by the insurance company.

Carney said, It’s insurers who are choosing to close plans, "the administration doesn’t step in" to force cancellations. Instead, "the insurer is making a decision to basically cancel the plan and reissue or offer the individual a new plan with different benefits or different costs."

Jarrett tweetedT it was a "fact" that "nothing in Obamacare forces people out of their health plans."

And here is the Grandfather Rule direct from Sebelius' HHS website, admit it, you've been lied to by the Right and you swallowed their lies without question!

U.S. Departments of Health and Human Services, Labor, and Treasury Issue Regulation on ?Grandfathered? Health Plans under the Affordable Care Act

“The Affordable Care Act gives American families more control over their health care by providing greater benefits, cost savings and protections,” said Secretary of Health and Human Services Kathleen Sebelius. “Today, with the announcement of the new ‘grandfather’ rule, we’re providing the market stability and flexibility to ensure that families and businesses can make the choices that work best for them.”

While the Affordable Care Act requires all health plans to provide important new benefits to consumers, under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The “grandfather rule” issued today makes it clear that these plans can continue to innovate and contain costs by allowing insurers and employers to make routine changes without losing grandfather status. Plans will lose their “grandfather” status if they choose to significantly cut benefits or increase out-of-pocket spending for consumers – and consumers in plans that make such changes will gain new consumer protections.

“The rule we are announcing today will allow employers to make routine and modest adjustments to co-payments, deductibles and employer contributions to their employees’ premiums without forfeiting grandfather status. This flexibility will encourage employers to continue offering health coverage to their employees and help to ensure coverage for all Americans,” said Secretary of Labor Hilda Solis.

Two problems with your quote; one remember all those exemptions that were handed out to various employers? That's what the above is in context to as you will notice it mentions nothing about the individual market. Only insurance provided through employers. The exemptions were granted because of the increased costs to the employers of these new plans.

2nd problem is even though it's still talking about just employer provided insurance it is still about as vague as it gets;

....requires all health plans to provide important new benefits....plans that existed before March 23, 2010 are exempt from some new requirements

Well which is it? Specifically what requirements are they exempt from? What about people who are happy with the plans that existed before that date? Obama made his statement about getting to keep your plan with ZERO qualification. There was no 'unless it was purchase before March 23, 2010.', in any of those speeches.' What constitutues a 'modest adjustment' in rates and/or deductibles? Did you consider that Obama's new requirements might render it impossible to make modest adjustments in price to those plans?

You can't be serious!
You just can't admit it is the insurance industry cancelling the insurance plans and not the ACA.

 

[Bern80]

Gee, what a surprise....NOT!
You give the Right the facts and they claim the facts are biased!!!

And Carney, Sebelius and others have made that very point, only to be called liars for telling the truth. Any plan in effect before the ACA was passed, no matter how shitty or nonconforming it is, can be grandfathered by the insurance company.

Carney said, It’s insurers who are choosing to close plans, "the administration doesn’t step in" to force cancellations. Instead, "the insurer is making a decision to basically cancel the plan and reissue or offer the individual a new plan with different benefits or different costs."

Jarrett tweetedT it was a "fact" that "nothing in Obamacare forces people out of their health plans."

And here is the Grandfather Rule direct from Sebelius' HHS website, admit it, you've been lied to by the Right and you swallowed their lies without question!

U.S. Departments of Health and Human Services, Labor, and Treasury Issue Regulation on ?Grandfathered? Health Plans under the Affordable Care Act

“The Affordable Care Act gives American families more control over their health care by providing greater benefits, cost savings and protections,” said Secretary of Health and Human Services Kathleen Sebelius. “Today, with the announcement of the new ‘grandfather’ rule, we’re providing the market stability and flexibility to ensure that families and businesses can make the choices that work best for them.”

While the Affordable Care Act requires all health plans to provide important new benefits to consumers, under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The “grandfather rule” issued today makes it clear that these plans can continue to innovate and contain costs by allowing insurers and employers to make routine changes without losing grandfather status. Plans will lose their “grandfather” status if they choose to significantly cut benefits or increase out-of-pocket spending for consumers – and consumers in plans that make such changes will gain new consumer protections.

“The rule we are announcing today will allow employers to make routine and modest adjustments to co-payments, deductibles and employer contributions to their employees’ premiums without forfeiting grandfather status. This flexibility will encourage employers to continue offering health coverage to their employees and help to ensure coverage for all Americans,” said Secretary of Labor Hilda Solis.

Two problems with your quote; one remember all those exemptions that were handed out to various employers? That's what the above is in context to as you will notice it mentions nothing about the individual market. Only insurance provided through employers. The exemptions were granted because of the increased costs to the employers of these new plans.

2nd problem is even though it's still talking about just employer provided insurance it is still about as vague as it gets;

....requires all health plans to provide important new benefits....plans that existed before March 23, 2010 are exempt from some new requirements

Well which is it? Specifically what requirements are they exempt from? What about people who are happy with the plans that existed before that date? Obama made his statement about getting to keep your plan with ZERO qualification. There was no 'unless it was purchase before March 23, 2010.', in any of those speeches.' What constitutues a 'modest adjustment' in rates and/or deductibles? Did you consider that Obama's new requirements might render it impossible to make modest adjustments in price to those plans?

You can't be serious!
You just can't admit it is the insurance industry cancelling the insurance plans and not the ACA.

I'm happy to admit it when it's true. But what you're citing just doesn't make any sense in light of your contention. Put yourself in the shoes of the 'evil' insurance companies. Right now it is predicted that the majority of plans on the individual market will be cancelled by next year. Why would a business voluntarily do that? Why would they sacrifice a gaurunteed revenue stream for only the possibility of a maybe greater income stream?

There's just too much spin, rhetoric and vagueness in the paragraphs you cited to make this new excuse believable and the source is coming from the same side of the political aisle that said it wouldn't happen in the first place. Again he stated that with NO qualification. He didn't say the government won't force you to change plans, but your insurer might. Even if what you say is true about the ACA what Obama said is STILL a lie unless he's a complete idiot that couldn't possibly foresee how the insurance companies would respond. And why did Obama apologize for something he has nothing to apolgize for in his interview yesterday? He never made the excuse that you're making. There's only one reason he wouldn't bring that up if what you say is true of the individual market; he's such collusion with the insurance companies that he can't throw them under the bus.

I think it's the distinction you're missing between the employer market and the individual market. It looks and reads to me that the grandfathering mentioned are basically the exemptions that were granted in the employer based market. The individuall market is an entirely different matter where no such exemptions were granted. Here's an article talking about that distinction, but in a nutshell employer baseed plans received signifacntly more leniency in what plans would be grandfathered than the individual market did.

http://dailycaller.com/2013/11/04/o...ules-to-benefit-big-business-not-individuals/

 

[edthecynic]

Two problems with your quote; one remember all those exemptions that were handed out to various employers? That's what the above is in context to as you will notice it mentions nothing about the individual market. Only insurance provided through employers. The exemptions were granted because of the increased costs to the employers of these new plans.

2nd problem is even though it's still talking about just employer provided insurance it is still about as vague as it gets;



Well which is it? Specifically what requirements are they exempt from? What about people who are happy with the plans that existed before that date? Obama made his statement about getting to keep your plan with ZERO qualification. There was no 'unless it was purchase before March 23, 2010.', in any of those speeches.' What constitutues a 'modest adjustment' in rates and/or deductibles? Did you consider that Obama's new requirements might render it impossible to make modest adjustments in price to those plans?

You can't be serious!
You just can't admit it is the insurance industry cancelling the insurance plans and not the ACA.

I'm happy to admit it when it's true. But what you're citing just doesn't make any sense in light of your contention. Put yourself in the shoes of the 'evil' insurance companies. Right now it is predicted that the majority of plans on the individual market will be cancelled by next year. Why would a business voluntarily do that? Why would they sacrifice a gaurunteed revenue stream for only the possibility of a maybe greater income stream?

There's just too much spin, rhetoric and vagueness in the paragraphs you cited to make this new excuse believable and the source is coming from the same side of the political aisle that said it wouldn't happen in the first place. Again he stated that with NO qualification. He didn't say the government won't force you to change plans, but your insurer might. Even if what you say is true about the ACA what Obama said is STILL a lie unless he's a complete idiot that couldn't possibly foresee how the insurance companies would respond. And why did Obama apologize for something he has nothing to apolgize for in his interview yesterday? He never made the excuse that you're making. There's only one reason he wouldn't bring that up if what you say is true of the individual market; he's such collusion with the insurance companies that he can't throw them under the bus.

I think it's the distinction you're missing between the employer market and the individual market. It looks and reads to me that the grandfathering mentioned are basically the exemptions that were granted in the employer based market. The individuall market is an entirely different matter where no such exemptions were granted. Here's an article talking about that distinction, but in a nutshell employer baseed plans received signifacntly more leniency in what plans would be grandfathered than the individual market did.

Obama modified 'grandfathering' rules to benefit businesses | The Daily Caller

The perpetual dumb act is wearing thin.

First of all, the insurance industry started canceling policies before the exchanges were started so their suckers would not be able to find out they could get better plans for the same or less money. As the link I gave said, they pressured their suckers to sign up while they were still in the dark and then called it Capitalism at work! Think about it, this was their very last chance to gouge their suckers before the ACA forced them to be honest brokers. The temptation to cheat is too great in Capitalism for them to pass up. It is simply Capitalism in action.

And no matter how much you pretend that the grandfather rules don't apply to individual policies, the website makes it clear that it applies to ALL plans and only makes a distinction for employer based plans later on.

Let me cite the HHS website again:

"The new regulation protects the ability of individuals and businesses to keep their current plan"

 

[Amelia]

Let me cite the HHS website again:

"The new regulation protects the ability of individuals and businesses to keep their current plan"

That's deception on both counts -- individual and business.

 

[Quantum Windbag]

How did they lie, the old policy does not meet the new requirements for old people, well past child bearing age, to buy maternity care. It also, more than likely, didn't cover substance abuse treatment, which is a favorite bogeymen of idiots, or pediatric treatment.

On the other hand, it had lower premiums, a lower deductible, a larger network, and lower copays.

Not to worry though, the new plan is better because you say it is.

If you notice, the Right always play dumb so they can repeat their same lie over again. The Right does not play dumb because they are stupid, they play dumb because they love to lie.

Again, no plan in effect before the ACA became law needs to add maternity care, substance abuse treatment, or pediatric treatment, that is just a GOP scripted lie that the insurance industry sees as an opportunity to cash in on by piggybacking on the GOP lie. As I showed with my link, the insurance industry sees this as Capitalism at its best!!!

If that is true then why are the insurance companies canceling people's plans? If the law allows people to keep plans that don't meet ACA requirements why would the insurance companies be sending out letters by the hundreds of thousands for that very reason?

They are cancelling the policies because it is required by Obamacare regulations, even Sebelius admits that, even if she thinks she can't change them.

 

[edthecynic]

If you notice, the Right always play dumb so they can repeat their same lie over again. The Right does not play dumb because they are stupid, they play dumb because they love to lie.

Again, no plan in effect before the ACA became law needs to add maternity care, substance abuse treatment, or pediatric treatment, that is just a GOP scripted lie that the insurance industry sees as an opportunity to cash in on by piggybacking on the GOP lie. As I showed with my link, the insurance industry sees this as Capitalism at its best!!!

If that is true then why are the insurance companies canceling people's plans? If the law allows people to keep plans that don't meet ACA requirements why would the insurance companies be sending out letters by the hundreds of thousands for that very reason?

They are cancelling the policies because it is required by Obamacare regulations, even Sebelius admits that, even if she thinks she can't change them.

You just can't stop yourself from LYING!

From the ACA:

Plans that successfully preserve their grandfathered status will escape these requirements:

Health insurance companies underwriting fully insured plans that are not grandfathered must determine premiums for using adjusted community rating rules. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
Health insurance companies underwriting fully insured plans that are not grandfathered must offer coverage on a guaranteed issue and guaranteed renewal basis. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
All nongrandfathered group health plans -- fully insured and self-insured -- will be prohibited from discriminating in their choice of health care providers that may serve as participating health care providers. (2014)
Health insurance companies underwriting fully insured group health plans in the small group market (employers with 100 or fewer employees) that are not grandfathered will be required include the “essential health benefits package” necessary for a plan to constitute a “qualified health plan” and participate in the health exchanges. (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must satisfy the limits on annual cost-sharing that accompany the “essential benefits package -- the HSA annual cost-sharing limit of $2,000/$4,000 (single/other). (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must not deny participation in, and must cover routine patient costs of, individuals with respect to participation in approved clinical trials involving cancer or other life-threatening conditions. (Plan years beginning after September 23, 2010.)
All nongrandfathered group health plans -- fully insured and self-insured -- must cover certain preventive services, immunizations, and screenings, without any cost sharing. (Plan years beginning after September 23, 2010.)
Comply with the nondiscrimination rules in Internal Revenue Code §105(h)(2) -- which, prior to the passage of the Affordable Care Act, only applied to self-insured plans. These rules prohibit discrimination in favor of highly compensated individuals as to eligibility to participate or as to benefits. (Plan years beginning after September 23, 2010.)
Not only provide for an internal appeals process for coverage determinations (the Affordable Care Act codifies the existing Department of Labor claims review regulations, shortening the time within which urgent health claims must be adjudicated) but also comply with any applicable State external review process requiring independent review of claims denied for medical reasons. If the State has not established an external review process that meets minimum standards or the plan is self-insured, the plan or issuer must implement an external review process that meets standards to be established by the Federal government. (Plan years beginning after September 23, 2010.)
Plans/insurers may not limit types of providers that may serve as primary care providers; plans/insurers that cover emergency services may not require prior authorization and must afford in- and out-of-network providers with the same coverage limits and cost-sharing; prohibits requiring referrals for OB/Gyn services. (Plan years beginning after September 23, 2010.)

 

[Quantum Windbag]

If that is true then why are the insurance companies canceling people's plans? If the law allows people to keep plans that don't meet ACA requirements why would the insurance companies be sending out letters by the hundreds of thousands for that very reason?

They are cancelling the policies because it is required by Obamacare regulations, even Sebelius admits that, even if she thinks she can't change them.

You just can't stop yourself from LYING!

From the ACA:

Plans that successfully preserve their grandfathered status will escape these requirements:

Health insurance companies underwriting fully insured plans that are not grandfathered must determine premiums for using adjusted community rating rules. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
Health insurance companies underwriting fully insured plans that are not grandfathered must offer coverage on a guaranteed issue and guaranteed renewal basis. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
All nongrandfathered group health plans -- fully insured and self-insured -- will be prohibited from discriminating in their choice of health care providers that may serve as participating health care providers. (2014)
Health insurance companies underwriting fully insured group health plans in the small group market (employers with 100 or fewer employees) that are not grandfathered will be required include the “essential health benefits package” necessary for a plan to constitute a “qualified health plan” and participate in the health exchanges. (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must satisfy the limits on annual cost-sharing that accompany the “essential benefits package -- the HSA annual cost-sharing limit of $2,000/$4,000 (single/other). (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must not deny participation in, and must cover routine patient costs of, individuals with respect to participation in approved clinical trials involving cancer or other life-threatening conditions. (Plan years beginning after September 23, 2010.)
All nongrandfathered group health plans -- fully insured and self-insured -- must cover certain preventive services, immunizations, and screenings, without any cost sharing. (Plan years beginning after September 23, 2010.)
Comply with the nondiscrimination rules in Internal Revenue Code §105(h)(2) -- which, prior to the passage of the Affordable Care Act, only applied to self-insured plans. These rules prohibit discrimination in favor of highly compensated individuals as to eligibility to participate or as to benefits. (Plan years beginning after September 23, 2010.)
Not only provide for an internal appeals process for coverage determinations (the Affordable Care Act codifies the existing Department of Labor claims review regulations, shortening the time within which urgent health claims must be adjudicated) but also comply with any applicable State external review process requiring independent review of claims denied for medical reasons. If the State has not established an external review process that meets minimum standards or the plan is self-insured, the plan or issuer must implement an external review process that meets standards to be established by the Federal government. (Plan years beginning after September 23, 2010.)
Plans/insurers may not limit types of providers that may serve as primary care providers; plans/insurers that cover emergency services may not require prior authorization and must afford in- and out-of-network providers with the same coverage limits and cost-sharing; prohibits requiring referrals for OB/Gyn services. (Plan years beginning after September 23, 2010.)

Tell me something, if I am lying, why did Obama apologize?

 

[daveman]

Tell me something, if I am lying, why did Obama apologize?

This should be amusing.

Go ahead, Ed. I can't WAIT to hear this!

 

[edthecynic]

They are cancelling the policies because it is required by Obamacare regulations, even Sebelius admits that, even if she thinks she can't change them.

You just can't stop yourself from LYING!

From the ACA:

Plans that successfully preserve their grandfathered status will escape these requirements:

Health insurance companies underwriting fully insured plans that are not grandfathered must determine premiums for using adjusted community rating rules. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
Health insurance companies underwriting fully insured plans that are not grandfathered must offer coverage on a guaranteed issue and guaranteed renewal basis. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
All nongrandfathered group health plans -- fully insured and self-insured -- will be prohibited from discriminating in their choice of health care providers that may serve as participating health care providers. (2014)
Health insurance companies underwriting fully insured group health plans in the small group market (employers with 100 or fewer employees) that are not grandfathered will be required include the “essential health benefits package” necessary for a plan to constitute a “qualified health plan” and participate in the health exchanges. (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must satisfy the limits on annual cost-sharing that accompany the “essential benefits package -- the HSA annual cost-sharing limit of $2,000/$4,000 (single/other). (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must not deny participation in, and must cover routine patient costs of, individuals with respect to participation in approved clinical trials involving cancer or other life-threatening conditions. (Plan years beginning after September 23, 2010.)
All nongrandfathered group health plans -- fully insured and self-insured -- must cover certain preventive services, immunizations, and screenings, without any cost sharing. (Plan years beginning after September 23, 2010.)
Comply with the nondiscrimination rules in Internal Revenue Code §105(h)(2) -- which, prior to the passage of the Affordable Care Act, only applied to self-insured plans. These rules prohibit discrimination in favor of highly compensated individuals as to eligibility to participate or as to benefits. (Plan years beginning after September 23, 2010.)
Not only provide for an internal appeals process for coverage determinations (the Affordable Care Act codifies the existing Department of Labor claims review regulations, shortening the time within which urgent health claims must be adjudicated) but also comply with any applicable State external review process requiring independent review of claims denied for medical reasons. If the State has not established an external review process that meets minimum standards or the plan is self-insured, the plan or issuer must implement an external review process that meets standards to be established by the Federal government. (Plan years beginning after September 23, 2010.)
Plans/insurers may not limit types of providers that may serve as primary care providers; plans/insurers that cover emergency services may not require prior authorization and must afford in- and out-of-network providers with the same coverage limits and cost-sharing; prohibits requiring referrals for OB/Gyn services. (Plan years beginning after September 23, 2010.)

Tell me something, if I am lying, why did Obama apologize?

You obviously know you are lying or you would not be trying so hard to change the subject.

 

[Quantum Windbag]

You just can't stop yourself from LYING!

From the ACA:

Plans that successfully preserve their grandfathered status will escape these requirements:

Health insurance companies underwriting fully insured plans that are not grandfathered must determine premiums for using adjusted community rating rules. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
Health insurance companies underwriting fully insured plans that are not grandfathered must offer coverage on a guaranteed issue and guaranteed renewal basis. (NB: Self-insured group health plans -- whether or not grandfathered -- are not subject to this requirement.)
All nongrandfathered group health plans -- fully insured and self-insured -- will be prohibited from discriminating in their choice of health care providers that may serve as participating health care providers. (2014)
Health insurance companies underwriting fully insured group health plans in the small group market (employers with 100 or fewer employees) that are not grandfathered will be required include the “essential health benefits package” necessary for a plan to constitute a “qualified health plan” and participate in the health exchanges. (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must satisfy the limits on annual cost-sharing that accompany the “essential benefits package -- the HSA annual cost-sharing limit of $2,000/$4,000 (single/other). (2014)
All nongrandfathered group health plans -- fully insured and self-insured -- must not deny participation in, and must cover routine patient costs of, individuals with respect to participation in approved clinical trials involving cancer or other life-threatening conditions. (Plan years beginning after September 23, 2010.)
All nongrandfathered group health plans -- fully insured and self-insured -- must cover certain preventive services, immunizations, and screenings, without any cost sharing. (Plan years beginning after September 23, 2010.)
Comply with the nondiscrimination rules in Internal Revenue Code §105(h)(2) -- which, prior to the passage of the Affordable Care Act, only applied to self-insured plans. These rules prohibit discrimination in favor of highly compensated individuals as to eligibility to participate or as to benefits. (Plan years beginning after September 23, 2010.)
Not only provide for an internal appeals process for coverage determinations (the Affordable Care Act codifies the existing Department of Labor claims review regulations, shortening the time within which urgent health claims must be adjudicated) but also comply with any applicable State external review process requiring independent review of claims denied for medical reasons. If the State has not established an external review process that meets minimum standards or the plan is self-insured, the plan or issuer must implement an external review process that meets standards to be established by the Federal government. (Plan years beginning after September 23, 2010.)
Plans/insurers may not limit types of providers that may serve as primary care providers; plans/insurers that cover emergency services may not require prior authorization and must afford in- and out-of-network providers with the same coverage limits and cost-sharing; prohibits requiring referrals for OB/Gyn services. (Plan years beginning after September 23, 2010.)

Tell me something, if I am lying, why did Obama apologize?

You obviously know you are lying or you would not be trying so hard to change the subject.

Thanks for the laugh.

I started this thread, the subject is about how Obama lied, and people are getting screwed. You claim that I am lying and that it is entirely the insurance companies that are at fault.

Obama apologized, why?

 

[edthecynic]

Tell me something, if I am lying, why did Obama apologize?

You obviously know you are lying or you would not be trying so hard to change the subject.

Thanks for the laugh.

I started this thread, the subject is about how Obama lied, and people are getting screwed. You claim that I am lying and that it is entirely the insurance companies that are at fault.

Obama apologized, why?

I PROVED the Insurance industry lied, you mindlessly parroted their lie.

The insurance industry should have apologized, not Obama apologizing for them!

 

[daveman]

You obviously know you are lying or you would not be trying so hard to change the subject.

Thanks for the laugh.

I started this thread, the subject is about how Obama lied, and people are getting screwed. You claim that I am lying and that it is entirely the insurance companies that are at fault.

Obama apologized, why?

I PROVED the Insurance industry lied, you mindlessly parroted their lie.

The insurance industry should have apologized, not Obama apologizing for them!

Ladies and gentlemen, ^^^^^ is what it means to be a mindless Obamabot.

 

[Quantum Windbag]

You obviously know you are lying or you would not be trying so hard to change the subject.

Thanks for the laugh.

I started this thread, the subject is about how Obama lied, and people are getting screwed. You claim that I am lying and that it is entirely the insurance companies that are at fault.

Obama apologized, why?

I PROVED the Insurance industry lied, you mindlessly parroted their lie.

The insurance industry should have apologized, not Obama apologizing for them!

Obama did not apologize for the insurance companies, Obama apologized for what he did. Why?

 

[NYcarbineer]

“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.

So even the 'victims' here admit their case is the most extreme. I'm sure all of the most extreme examples that are in no way representative will eventually get posted on USMB.

 

[Quantum Windbag]

“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.

So even the 'victims' here admit their case is the most extreme. I'm sure all of the most extreme examples that are in no way representative will eventually get posted on USMB.

This does not even crack the top ten in extreme, maybe he should pay more attention.

 

[NYcarbineer]

“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.

So even the 'victims' here admit their case is the most extreme. I'm sure all of the most extreme examples that are in no way representative will eventually get posted on USMB.

This does not even crack the top ten in extreme, maybe he should pay more attention.

So now you're resorting to impeaching the credibility of your own witness.

lolol.

Why don't you post the top ten worst cases, supported by credible evidence?

 

[Bern80]

You can't be serious!
You just can't admit it is the insurance industry cancelling the insurance plans and not the ACA.

I'm happy to admit it when it's true. But what you're citing just doesn't make any sense in light of your contention. Put yourself in the shoes of the 'evil' insurance companies. Right now it is predicted that the majority of plans on the individual market will be cancelled by next year. Why would a business voluntarily do that? Why would they sacrifice a gaurunteed revenue stream for only the possibility of a maybe greater income stream?

There's just too much spin, rhetoric and vagueness in the paragraphs you cited to make this new excuse believable and the source is coming from the same side of the political aisle that said it wouldn't happen in the first place. Again he stated that with NO qualification. He didn't say the government won't force you to change plans, but your insurer might. Even if what you say is true about the ACA what Obama said is STILL a lie unless he's a complete idiot that couldn't possibly foresee how the insurance companies would respond. And why did Obama apologize for something he has nothing to apolgize for in his interview yesterday? He never made the excuse that you're making. There's only one reason he wouldn't bring that up if what you say is true of the individual market; he's such collusion with the insurance companies that he can't throw them under the bus.

I think it's the distinction you're missing between the employer market and the individual market. It looks and reads to me that the grandfathering mentioned are basically the exemptions that were granted in the employer based market. The individuall market is an entirely different matter where no such exemptions were granted. Here's an article talking about that distinction, but in a nutshell employer baseed plans received signifacntly more leniency in what plans would be grandfathered than the individual market did.

Obama modified 'grandfathering' rules to benefit businesses | The Daily Caller

The perpetual dumb act is wearing thin.

First of all, the insurance industry started canceling policies before the exchanges were started so their suckers would not be able to find out they could get better plans for the same or less money. As the link I gave said, they pressured their suckers to sign up while they were still in the dark and then called it Capitalism at work! Think about it, this was their very last chance to gouge their suckers before the ACA forced them to be honest brokers. The temptation to cheat is too great in Capitalism for them to pass up. It is simply Capitalism in action.

And no matter how much you pretend that the grandfather rules don't apply to individual policies, the website makes it clear that it applies to ALL plans and only makes a distinction for employer based plans later on.

Let me cite the HHS website again:

"The new regulation protects the ability of individuals and businesses to keep their current plan"

That's simpy not true. The individual market was not afforded the same exemptions and grandfathering rules that the employer based market was. Again your quote is completely vague, void of detail, and comes from the source trying to sell the bill. If you're so biased that you actually believe that's what the above quote means coming from the side trying to sell the ACA to begin with, you're simply too naive to even have a debate with.

Again look at it logically. If what you say is true than why is NOBODY in the administration or the main stream media clarifying this or shifting the blame to the insurance companies? Of course the insurance companies were canceling plans in advance of Obamacare. They knew they wouldn't be qualified. You just keep shooting yourself in the foot Ed. You think your providing evidence for your side when you're actually helping the other side. Your list of exptions that will be grandfathered in is pretty short when you cut through the political speak. It mentions nothing about the various type of coverage that Obama is mandating that current plans lack being grandfatherd in and that is the reason for the bulk of the cancellations on the individual market.