<p>Calmom, and do you need a vote by congress to make the change?</p>
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Who said that the grandfathered plans have to keep Cedars? A PPO can change its networks any time-- I assume there is probably some state law requiring a reasonable notice period – but I imagine a letter would go out saying that contracts with such-and-such facilities had been terminated and were not being renewed, perhaps with an attached list of the remaining large in-network facilities.</p>
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<p>I think some of the people calling for a legislative fix to allow people to “keep their current insurance” are asking for a right they’ve never had–the right to keep their current insurance plan, with their current insurer, at the current price, and with the same provider network. That’s not something insurance companies have ever promised or provided. They’ve always reserved the right to change the plan terms at the end of the current coverage period, and typically have changed the terms annually, or canceled some plans entirely, or terminated people who thought they had good insurance coverage, essentially for becoming sick (often digging up some pretextual “preexisting condition” to justify the cancellation).</p>
<p>I’ve been covered by employer-sponsored group coverage for just about as long as I can remember. I can never remember a year when the provider, coverage, price (i.e., my share of the premium as employee, plus co-pays and deductibles), and provider network stayed constant from one year to the next. Sometimes the provider opted out, and my employer had to scramble to find replacement coverage. Sometimes coverage grew, sometimes it shrank, but grow or shrink, my share of the cost inexorably increased from one year to the next. Same with the provider network–sometimes it grew, sometimes it shrank, or it grew in some areas and shrank in others, but each year I paid more. And my employer never promised, and could never promise, that if I liked my current insurance company and my current insurance plan, that same company and its same plan would be available to me the next year–much less that it would be available at the same price, with the same provider network.</p>
<p>I just think there’s a lot of la-la-land thinking about this.</p>
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Here’s a video that explains how this is done: [I'm</a> Just a Bill (Schoolhouse Rock!) - YouTube](<a href=“http://www.youtube.com/watch?v=tyeJ55o3El0]I’m”>http://www.youtube.com/watch?v=tyeJ55o3El0)</p>
<p>"I don’t think “nationalism” is the word you folks are looking for here. Nationalism is just excessive patriotism. Nationalize is the word you want. "</p>
<p>You’re right. Nothing wrong with a little bit of nationalism, but yeah, nationalize isn’t such a great idea (see Venezuela).</p>
<p>“Who said that the grandfathered plans have to keep Cedars? A PPO can change its networks any time–”</p>
<p>Can a grandfathered plan change from a ppo to an epo?</p>
<p>Bclintonk, I like your post.</p>
<p>I am learning a lot here. Good thing calmom is here too. :)</p>
<p>“If I were Bashar Assad I’d head to the bunker about now ;-)”</p>
<p>That’s pretty funny, maybe you’re predicting the near future?</p>
<p>Congress can change the grandfathering date. However, they can’t force any company to keep the specifics of a plan exact in terms of network reach and premium prices.</p>
<p>So GP might get grandfathered legally only to find his grandfathered plan has been altered to the same reach and price as his new plan.</p>
<p>Come to think of it, if they alter the date, many other people’s prices can also change automatically.</p>
<p>One of my colleagues loved Kelsey Seybold. Last year or the year before he was frantically getting a bunch of tests completed in the middle of the year because the insurance plan he was on (one of several employer plans) was dropping Kelsey long before the year ended because their contract was up and they did not renew.</p>
<p>Yes, I stand corrected. I meant nationalize.</p>
<p>“Come to think of it, if they alter the date, many other people’s prices can also change automatically.”</p>
<p>How does that work that other people’s prices can change automatically?</p>
<p>The group risk profile has been altered by stroke of a pen.</p>
<p>They had 1000 (pick any other random number) people who are allowed due to the grandfather clause whose profiles are well documented as well as costs.</p>
<p>Now you have another 1000 who may become eligible due to the extended date whose risks and costs are different.</p>
<p>Interesting. Thanks.</p>
<p>If only there were no pesky 80% rule, FangCo might get behind GP’s wish. Because, remember, those cherry picked healthy people have to be treated as if they were in the general risk pool. It’s the law, says FangCo CEO Cardinal Fang piously. The plan has very generous benefits, and unfortunately we have to bill these extremely healthy people as if they’re going to be heavy users of those luxurious hospitals. We’re SO sorry, but we must follow the law. Why yes, the other policy is quite a lot cheaper but you wanted this one.</p>
<p>Calmom, “I am just a bill” is great.</p>
<p>Thanks.</p>
<p>Calmom , we are in agreement with your proposed solution in your post # 4331. Sign me on to this amendment.</p>
<p>dstark, you would be the last person who I would have testify on my behalf at any legal proceeding with which I am involved. :)</p>
<p>As for the issues of premium rate hikes and changing networks, I am willing to take my chances, no different than what I have experienced in the past. At least I start with a robust network and a lower premium instead of a very narrow network, much higher premium…and the faint hope it will get better.</p>
<p>GP, it’s not going to happen because the cancellation of our policies seems to be a California-only issue – it’s clear that other states are interpreting the law to allow non-grandfathered policies to be renewed for a year up through December. California also seems to be the state that is leading the nation in the number of signups to the exchange – so if anything, California has become a model of how ACA is supposed to work.</p>
<p>I think your perspective would be different if you had received a renewal notice rather than a cancellation notice, because your renewal notice would have likely included a rate increase for the coming year. You still might want to stick with your old plan because of the network, but you’d at least be making that decision with your 2014 rates in mind.</p>
<p>Calmom, Ca had 35,000 signups. How many of those people have paid any money? Until some money has passed hands, I am not going to believe any of those shopping cart signups are real. </p>
<p>Regardless, Ca needs to signup 1.3 million people in the first year. If you want to call this a success, go ahead, but I call it an epic failure. It is even worse when one million people are cancelled in Ca and we have only 35,000 people with plans in a shopping cart. The rollout of Obamacare has been a disaster and no amount of spin is going to change it.</p>
<p>This reminds me when in July I read a news report that Peter Lee, the director of Covered Ca., announced with great fanfare the premiums for exchange plans were 25% less than existing plans. They had issued preliminary pricing for typical plans in each region and age groups. I looked up the information for my age group and discovered my plan was going up 75%. That is when I knew I couldn’t trust anything coming out of Sacramento.</p>
<p>I like dstarks solution. Write a simple law allowing people to buy ACA insurance with subsidies through the insurance companies and estimate the subsidies. IRS can review at tax time and clawback if necessary. From the customer. </p>
<p>Then shut the exchanges that don’t work and get them fixed and secure. I’m emailing this to both my senator and congressperson in both states I’ve lived and paid taxes this year.</p>
<p>The insurance companies will cooperate. They should be coming up with these solutions themselves unless they think the alternative will be to go back to the way it was. It won’t be. Single payor will be the next step if the insurance companies don’t handle this, IMHO.</p>
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<p>My policy is being cancelled and I’m in Rhode Island. We’re being rolled into a new policy - my premiums will increase from $637 a month to about $1275 - my family deductible will increase from $10K to $11,600. Oh, and I’m not eligible for a subsidy and only one insurer (Blue Cross) in my state offers private insurance. So, I have no choice but to deal with a twice as expensive premium for less insurance - or at least even more out of pocket. Because we have been very healthy, the cheapest route seems to be the huge deductible. I’m hoping for at least a year to grandfather my old policy…</p>