Tag Archives: grandfathered plans

Big excitement over September 23? Not really

Yesterday a wave of changes scheduled under the Patient Protection and Affordable Care Act went into effect.  Lots of people seem excited, but unfortunately I’m afraid they don’t realize the changes won’t apply to most of us.  For example, insurers won’t be allowed to turn away or deny claims for those under 19 with pre-existing conditions– but this only applies to new plans.  So if you already have insurance, the rules won’t change for your children– and several large insurers have announced that they will no longer issue new individual policies for children.  They say the law just encourages families to wait until their children are sick to get insurance so it will be too expensive to cover them.

The same “grandfather effect” rules for the lifetime dollar limits for children, coverage for preventive services, and even new rights to appeal claims denials.

There is now a ban on rescinding coverage for people for frivolous reasons– if you make an honest mistake on your insurance application, they can’t cancel your policy when you get an expensive illness.  BUT– this was always the case, and it never stopped that kind of thing.  Maybe it will help that now people know it is illegal, but most likely they will still wind up bogged down in court trying to appeal these cancellations.

The only improvement I see that isn’t ruined by the grandfather effect is that people can stay on their parents’ policies until they are 26.  But if they’ve developed a pre-existing condition during the time they were off, and it isn’t a new policy, then they are still out of luck.  I’m sure we will see all sorts of ways to keep plans grandfathered as long as possible– and I suspect there will be some creative ways private insurers will deal with the 19 to 25 year olds too.

As provisions of PPACA come into play, this will give us more opportunities to witness the misbehaviors of insurance companies as they scramble to get around every loophole they can find.  Maybe this will ultimately help people realize that we don’t need them at all– we can fund our own healthcare without these middlemen in the way.  Advocate for publicly funded, privately delivered healthcare– a new, improved version of Medicare for all of us.

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