THCB

Why Can’t I Change My Plan?

A THCB reader writes in with a question and a pretty disruptive suggestion. @NorCal Exchange writes:

“I’m a small business owner. I’m also a card-carrying Democrat. Frankly, I’m pretty pissed off about the way things have gone with this roll-out so far.  This was our one chance to get health reform right. And from what I can tell, we’ve totally screwed it up. Here’s one more thing a lot of the media coverage is missing. Even though THCB readers understand how open enrollment works, I’m guessing a lot of ordinary Americans don’t realize that under the new rules once they’ve applied for coverage they’re basically stuck with what they’ve got until the next enrollment period. This was a pretty big change in the first place. With all of this insanity, I’m guessing people are probably not reading the fine print and don’t know they’re locked in.

My prediction: there are going to be a lot of really unhappy people in the early part of 2014, when people realize what they’ve gotten themselves into. Why not allow people to change their plans? If you want an Amazon.com for healthcare, make the market for health insurance the same way as the market for anything else. If people decide to upgrade their coverage let them. If they get pissed at UnitedHealth’s customer service, let them cancel their policy and switch to AETNA or CIGNA. If I’m an idiot and don’t want preventative coverage let me build my own plan. If I’m worried that my daughter might get cancer let me add the Mayo clinic to my network. If my kid plays sports, let me add better ortho coverage. Yeah. Yeah. I know. This will turn the traditional underwriting model upside down. And a couple of health plans may even go out of business. But so what? My business may end up going out of business.  These guys are smart. They’ll figure out twenty new ways to make money and they’ll end up thanking us for disrupting their precious monopoly …”

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johnfaysamRobertBobby Gladd Recent comment authors
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john
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john

Well said. I am also a small business owner, in California (which I can only speak of) there are millions of angry folks. Personally, the only reason I was pulled into this mess is because my previous provider pulled their coverage from California, completely…100%. I was forced to switch. Not only had I hit my out-of-pocket maximum within the first two months of the year on the existing plan due to surgery, they stopped coverage in an instant; meaning no physical therapy. The new plan I selected was based on research I had done to ensure my doctors and therapist… Read more »

fay
Guest
fay

I just found out that I cannot switch my lousy health plan. they have to drop me in order to do so and if I stop paying them. I get penalize.
on my lousy health care my regular doctors request payment in front and I have to deal to be reimbursed , they even stop taking health plan.
this is a mess. I don’t know what is the congress doing?? I am very angry.

sam
Guest
sam

I am shocked how bad the plans are under this new law. In my family, we have 3 individual health plans. All three have been cancelled because of this law and now to get a similar plan, it is going to cost twice as much and the deductible will be higher. The affordable care plans are actually worse than what I had before except they cover mental health. I really hope this law gets revoked because it is going to really change my standard of living. I am looking at only having health insurance for my son now while me… Read more »

Peter1
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Peter1

Sam, you’re not just paying for mental health you’re paying for pre-exist, free check ups, women not being rated higher than men, no life time maximum, etc. I’m not a fan of the new law but it does make some popular mandates to plans that people never were included in before. Have you been able to get on the web site and get an idea what an exchange plan for the family will cost? Will you qualify for a subsidy? If you’re having trouble buying a plan it may be that you get the subsidy. The ACA was never meant… Read more »

Robert
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Robert

You can’t change your insurance plan randomly throughout the year because you can’t maintain a viable risk pool that way. You could shorten or lengthen the contract, but it would need to be consistent among all plan participants. You can’t pick and choose what diseases to cover because then only those people at high risk would choose an option for that disease coverage, thus destroying the risk pool. You can’t randomly add Mayo Clinic to your plan because if too many people did that then Mayo Clinic’s costs would soar and therefore your insurer’s costs. Insurance is not like everything… Read more »

Peter1
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Peter1

” I’m guessing a lot of ordinary Americans don’t realize that under the new rules once they’ve applied for coverage they’re basically stuck with what they’ve got until the next enrollment period.”

Why is this different than any other health plan? My wife’s work allows her to pick a plan – and only change it next enrollment – one year later.

No big deal.

Catherine
Guest
Catherine

Has anyone tried to get your cable company to go to a cafeteria plan? Which is essentially what the questioner is asking for. Your cable company won’t do it. With all sorts of reasons such as, “It would shut down the independent cable channels since so few people would want to watch them. You want those independent channels to have a place in the ‘free(?)’ market, don’t you?” Most cell phone companies want a contract as others have pointed out. And every organization I have worked for has open enrollment once a year for all the insurance plans the company… Read more »

Cindy
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Cindy

So we should let the people that are too lazy to actually look at what they are signing, have the ability to switch in and out of plans? How often? Once per year is enough. That is how Medicare plans work.

Barry Carol
Guest
Barry Carol

Medicare’s open enrollment period runs from October 15th through December 7th, You can stick with your current plan or pick a new one during that period. After that, you’re committed to it until the next open enrollment period beginning 10/15/2014. That’s the way the system works which is perfectly fair and reasonable in my opinion. Why should the ACA work any differently?

Cynthia
Guest
Cynthia

Keep in mind that small business is the enemy of the soul-less corporations. Just look at WalMart and the bling franchise eateries. Corporations set up layers of bureaucracy, a cultish culture, and an army of lawyers. They can grind an individual into dust and break their spirit with their gutless, heartless, mind-numbing procedures, paperwork, and HR departments.

This is why government and corporations collude; they understand each other.nA small business with ties to a community and the local economy is their worst enemy.

John Ballard
Guest

This complainer would love a Forbes article from last year, treating health care as a market commodity. http://www.forbes.com/sites/theapothecary/2012/05/21/putting-the-insurance-back-in-health-insurance/ This Epstein quote sticks in my craw… “A sounder system would have allowed health-insurance carriers to require the insureds to pay a penalty to withdraw from coverage, or to insist that they remain in the plan for some minimum period…. What phone companies can routinely do is thus systematically denied to health-insurance carriers.” Comparing health care with telephone service (or calling it “customer service” as the writer does) is transparently revealing. The notion of absorbing what the gene pool and serious medical… Read more »

MedicalQuack
Guest

And we are certainly hearing about insurers not happy but it needed some kind of a fix. I don’t know who the experts are here but probably some actuaries. If you have not taken notice of all the Quants being hired by insurers, do look at some classifieds. Quants are the geniuses that create the math models for black boxes on Wall Street for banks and hedge funds so we have the same thing going on with healthcare..it’s the battle of the machines and now the insurers will be bringing in the quants to model their next move. This actually… Read more »

Whatsen Williams
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Whatsen Williams

“And from what I can tell, we’ve totally screwed it up.”

Obama says he is as frustrated as anyone. Really? As frustrated as the family who just lost their coverage, and can not get on the website to replace it?

Yup, it is totally screwed up, just like HITECH here and NPfIT in the UK.

Andrew
Guest
Bobby Gladd
Guest

” just like HITECH”

Same Old Song.