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New health-care rules could add costs, and benefits, to some insurance plans

President Obama introduced his health-care plan at a joint session of Congress in September.
President Obama introduced his health-care plan at a joint session of Congress in September. (Richard A. Lipski/the Washington Post)
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To the extent that plans losing grandfathered status do not already offer those benefits, their costs could increase.

"This is not only bad news for the vast majority of Americans who like the plans they have. It also flatly contradicts the president's repeated promises," Senate Minority Leader Mitch McConnell (R-Ky.) said on the Senate floor.

Health and Human Services Secretary Kathleen Sebelius said in an interview that Obama "wanted to make sure as much as possible that if people had plans that they liked they got to keep them and balance that with, you know, some overall protection for consumers."

Obama's frequently repeated promise about keeping your coverage if you like it was problematic. Health plans routinely make changes. If the overhaul works as intended, many small businesses would send workers to new marketplaces called exchanges, where they could find more and better options. Over time, the exchanges could be opened to large employers, too.

The promise helped reassure a public nervous about change, but it also gave Obama's critics political ammunition.

Losing grandfathered status could be a bigger deal for small businesses than for large businesses because small employers' health plans could have more ground to make up to come into compliance.

Industry representatives said it was too soon to tell how much.

"The reality is, we're going to have to take a closer look at these rules," said Kathryn Wilber, senior counsel for health policy at the American Benefits Council, whose member companies sponsor or administer health plans. "They're a little more complicated than we would have liked, and it's really a plan-by-plan specific decision."

Judging the stakes is also complicated by the fact that rules implementing other aspects of the health-care overhaul have yet to be hammered out by regulators.

"For example, the law gives very little insight on what types of internal and external claims procedures a [non-grandfathered] plan would have to have in place," said Kelly Traw, a lawyer with Mercer, a human resources consulting firm. "It also does not spell out which preventive services a plan might offer."

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