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Reality Check

Reality Check

Vets the truthfulness of claims and measures the efficacy of public policy

Reality Check: Health Care 'Solution'? Not in CA



    In this edition of Reality Check, Sam Brock examines the claim policyholders can have another chance to keep their old insurance coverage. (Published Thursday, Nov. 14, 2013)

    Battered by criticism over his floundering health care reform plan, President Barack Obama looked to improve his standing with Americans Thursday, promising both comfort and solutions for those struggling to secure coverage.

    “I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked they could keep it,” Obama professed to a national audience. “And to those Americans, I hear you loud and clear.”

    First, the health care roll out was besieged by technical glitches [and still is].

    More recently, millions of people reported having their health care plans dropped, rankling the administration and heightening scrutiny.

    Mr. Obama told the country he has a possible fix for the dropped coverage.

    “The bottom line is insurers can [now] extend current plans that would otherwise be cancelled into 2014,” Obama said. “And Americans whose plans have been cancelled can choose to re-enroll in the same kind of plan.”

    But is that true in California?

    For the majority of the 1.1 million people in this state who’ve lost coverage, the answer appears to be no.

    According to California Insurance Commissioner Dave Jones, the problem lies in a contract provision between the state’s online
    exchange, ‘Covered California,’ and the providers selling on the exchange.

    “Over my objections, Covered California decided to include in their contracts with health insurers and HMOs selling policies in our
    health insurance exchange a provision requiring those individual and family policies to be cancelled by December 31, 2013,” Jones said.

    To be clear- it’s *mandated that all individual, non-grandfathered health policies offered by insurers selling on the exchange must be cancelled before the start of the year.

    To the chagrin of Jones, the idea was proposed by the insurance companies and ultimately agreed to by Covered California.

    “Unfortunately, neither state nor federal law allows me to stop the cancellations,” Jones said. “But I will do everything within my power to urge that California’s insurance companies and HMOs follow the president’s call,” he added.

    Jones wrote Covered California Executive Director Peter Lee following the president’s press conference, “urging” him to release insurance companies on the exchange from the contract provision.

    A Covered California spokesperson told NBC Bay Area the independent agency is still “assessing the impact and analyzing our options” following the announcement, and it’s not yet clear what the exchange’s board plans to do.

    Either way, the decision may be moot.

    The California Association of Health Plans, the trade group representing the providers selling in California, released a statement declaring that “California needs to stay the course and transition people into the more comprehensive policies that meet the requirements of the Affordable Care Act.”

    Further in the statement, the group added, “reversing course now could cause a significant disruption in the marketplace.”

    Bottom line? Even if the contract were somehow revised, it does not appear the insurance companies want to play ball.

    That will affect a lot of people. All of those folks with policies dropped by one of the 11 insurance companies contracted with Covered California, a group which includes state titans Anthem Blue Cross, Blue Shield and Kaiser, will almost certainly not be able to extend their old policies for another year.

    Jones said the insurance companies not contracted with the exchange are free to follow the president’s new policy.

    When asked how many of California’s 1.1 million policyholders whose coverage was dropped would be frozen out from the president’s plan, Jones responded, “I think it’s fair to say a majority of the individual policyholders covered by health insurers that have contracts.”

    The president’s solution intended to help “many” Americans with dropped coverage will likely be out of reach for most Californians.

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