When Jerry Buckley of Marion bought a health insurance plan for him and his wife two years ago, he wasn’t worried about whether he would be able to keep it after new regulations took effect under the federal Affordable Care Act.
"I didn’t pay any attention to that because the president kept telling you, this won’t affect you if you like what you have," Buckley said last week.
A few months ago, Buckley received a letter from Arkansas Blue Cross Blue Shield advising him that his plan does not comply with new standards taking effect Jan. 1 under the health care law. Buckley was told that he and his wife could stay on the plan through the end of 2014, thanks to an extension allowed by the Arkansas Insurance Department, but after that they would either be rolled over into a plan with triple the monthly premiums or they would have to shop for another plan.
Plans that were in effect when the Affordable Care Act was signed into law on March 23, 2010, are exempt, but the Buckleys are among millions of Americans who bought plans in the individual market that are not grandfathered in because they were purchased after that date.
The issue is giving more ammunition to opponents of the health care law who have also been sharply critical of the myriad technical problems surrounding the roll out of insurance marketplaces, including breakdowns in the national national website built to provide information and take applications for coverage.
Critics say President Obama’s repeated pledge that people who liked their insurance could keep it were at best misleading, as some Americans — estimates range from 7 million to 16 million — are on insurance that cannot continue to exist in its current form under the Affordable Care Act.
Supporters of the law say the people in that group will end up with fuller coverage, and many of them will be eligible for subsidies to help them buy insurance through the new insurance marketplaces.
But Buckley, whose income makes him ineligible for subsidies, doesn’t see an upside to switching. He said he likes his current plan, which has a $400 monthly premium, a $7,500 deductible and 100 percent coverage after the deductible, plus 80 percent coverage for dental and vision services.
He said that if he switches to the most closely comparable plan available through the Arkansas Health Insurance Marketplace, his monthly premium will increase to $600, his deductible will increase to $8,000 and he will have only 70 percent coverage after the deductible. Dental and vision coverage are not included but can be bought separately.
Buckley would gain some new benefits, such as coverage for maternity, mental health and substance abuse services, but he said he and his wife, who are middle-aged, neither want nor need those benefits.
"Our plan was custom-designed for our lifestyle," he said. "To sit there and mandate that every plan has to have maternity coverage in it is absolutely ridiculous."
The Arkansas News Bureau provided Buckley’s information to the state Insurance Department to see if he was correct in his comparison. Bruce Donaldson, stakeholder and producer specialist for the insurance marketplace, said Buckley was "about right."
Donaldson said premiums are going up because of the increases in benefits mandated by the Affordable Care Act and because the law requires guaranteed coverage — no one can be denied coverage or charged sky-high rates based on age, a health condition or other factors.
Donaldson said the good news for affected Arkansans is that the Insurance Department has allowed non-grandfathered plans to be extended through Dec. 31, 2014, and that by that time "there could be additional options for consumers as more carriers enter the marketplace and provide more competitive plans."
U.S. Sen. Mark Pryor, D-Ark., who voted for the Affordable Care Act, said Friday he is concerned about those who are losing their current plans, but he praised the state Insurance Department for allowing a one-year delay.
"I think they’re handling that in the right way, especially given the problems with the website, where people can’t go on the website and know for sure all of their options," he said.
U.S. Rep. Tom Cotton, R-Dardanelle, who is seeking the GOP nomination to challenge Pryor’s 2014 re-election bid, said Friday he supports proposed legislation that would allow people with non-grandfathered plans to keep them.
"You can say it’s a small percentage of people losing their health insurance, but tell that to an estimated 16 million Americans who are going to lose their health insurance who are very happy with their policy," he said. "It’s Barack Obama and bureaucrats in Washington saying, ‘We know better than you and your family about what suits your medical needs and your budgetary needs.’"
Anna Strong, health policy director for the nonprofit group Arkansas Advocates for Children and Families, which supports the Affordable Care Act, said that although some may not need maternity, mental health or substance abuse services, millions of Americans who do need them and have not previously had access to them under private plans are gaining that access under the federal law.
Strong cited a New Yorker article in which MIT professor Jonathan Gruber, an architect of Massachusetts’ health care law and the Affordable Care Act, estimated that 97 percent of insurance holders would see no change or get a better deal, and 3 percent would potentially get a worse deal. Gruber noted in the article that "no law in the history of America makes everyone better off."
Buckley said he contacted Pryor’s office and was told by a member of his staff that the health care law "only a small percentage of Americans buy insurance in the individual market."
"I was like, you know, that’s real good for the people that it’s benefiting, but what about the people that it’s hurting?" he said.