Brown: Obama’s broken promises unsurprising

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Photo: Kelsey Kremer/Iowa State

President Barack Obama speaks at Iowa State University in 2012.

Phil Brown

The Obama administration has recently been under heavy fire from seemingly all sides for the debacle that the Affordable Care Act rollout has become. One of the more piercing commentaries on how the president and his office have mishandled the health insurance reform is his famous promise that “If you like your insurance plan, you can keep it.” This is contrasted sharply with the multitudes of Americans who are now being notified that they cannot, in fact, keep their insurance plans.

This turn of events should not have come as a surprise to anyone.

That is not to say that a president’s promises are not be trusted in general. Instead, the nature of this specific promise is what makes it inherently subject to increased scrutiny.

The problem from which the president’s pledge intrinsically stemmed was that the government is not the only actor with the power to cancel insurance plans. The insurance providers themselves are absolutely relevant in these discussions, and Obama should never have made a promise that could so easily be broken by those who have so little sympathy for him and his promises.

When the president said that people could keep their plans and their doctors, what he meant was that current plans will be “grandfathered” into the new health insurance system. However, if an insurance company makes certain changes to a policy, it will no longer be considered the same plan and will be subject to the new regulations of the Affordable Care Act.

In order to be treated as an identical coverage, an insurance plan was originally not allowed to undergo “substantial” changes. Some of those “substantial” changes included a $5 — plus the cost of medical inflation since March 2010 — alteration to copay, a 5 percent decrease in an employer’s contribution since March 2010 and a variety of other really not-so-substantial changes.

The reasoning for such low thresholds in treating a plan as grandfathered are fairly clear. The health insurance reforms were intended to prevent current practices from continuing. Even if an insurer raised insurance costs to their policyholders, many would likely not even consider seeking new coverage.

Maybe this is because so many Americans absolutely loved their health insurance — even when its costs go up — or maybe this is because many have been told that they will, without exception, be paying more for new plans that offer “cadillac” suites of coverage.

Some of those so-called cadillac features include maternity care insurance, coverage of lab tests, and preventative care treatments like vaccines.

To be fair, many health insurance plans do not currently cover some of these requirements and their consumers may be just fine with this. One of the more ridiculous-sounding “Obamacare mandates” is that all insurance plans — even those bought by biological males — have to provide maternity coverage. This is touted as a criticism of the new regulations despite the fact that offering maternity insurance to men amounts to a whopping zero total cost for insurance companies.

What is more of an issue to insurance companies and those who wish to buy less than stellar health insurance policies are the required caveats like preventative care, substance abuse care, and pediatric care.

Unfortunately, these kinds of increased coverages are the direct necessity of the insurance mandate our Congress and president chose as the basis for their reform. The individual mandate was likely not many legislators’ — nor Obama’s — first choice, but that is the option that could be passed through both houses of Congress, and that is what we as a nation now have.

If we are going to have an individual mandate on health insurance, which is intended to draw younger and healthier people into the insurance pool, we simply have to have fairly high minimums on the coverages they can purchase.

It would be completely useless to make everyone buy insurance if, for example, someone could go out and get a $5-a-year plan that only provided coverage in the event that one was punched in the face by Mike Tyson or for any other comically implausible shenanigans.

Ultimately, the minimum requirements could be subverted if an insurance company continued to offer the same plan. The problem with this, from the perspective of the Obama administration, is that the insurance companies are not going to do him any favors.

After extensive reforms that promise to undercut their most sure-fire ways to increase profits, it should not be a shock to anyone that insurance companies would deliberately change their plans enough so that they can no longer be accepted. When this happens, the insurance company has every right to send their policyholders a wonderful notification telling them that their coverage will be canceled, and conveniently add that it is all thanks to President Obama.

That blame may be more than a little manufactured, but it certainly shouldn’t be surprising. All in all, President Obama should never have made a promise that he couldn’t keep, at least not without the help of the same companies on whom his signature legislation increased regulations.