Raymond Liu remembers President Barack Obama's promise that people would be able to keep their insurance if they liked it. He liked his, but he won't be able to keep it.
As Obama continues his campaign to win over Americans skeptical of the Affordable Care Act, the ranks of critics are growing, swollen by people such as Liu who are losing their existing health insurance because it does not comply with the law.
Liu is one of 73,000 Marylanders insured by nine insurance companies who will not be able to keep their policies because they were not grandfathered under the new health law. Only policies created before March 23, 2010, when the health law passed, can be grandfathered, according to the law.
Liu, 35, a self-employed Fulton resident, said he is healthy and not a big user of health care. He and his wife had a simple policy that suited their needs and cost about $300 a month, he said. After exploring new plans from CareFirst BlueCross BlueShield and on the state's new exchange for the uninsured, he learned that a similar policy might cost closer to $500 a month.
"This type of low-premium plan that provides for cheap preventive visits to the doctor is what I have always sought after," he said. "But they are no longer available under the so-called Affordable Care Act. The new plans are basically penalizing frugal, healthy lifestyle-seeking individuals such as myself and forcing us to fork over higher premiums for plans with higher deductibles and coverages that we don't need or want."
Around the country, many people like Liu are getting letters explaining that their plans will no longer be offered because they do not offer the minimum benefits required by the health law. The Maryland Insurance Administration said consumers should receive 90 days' notice if their plans are being discontinued, then they can look for new coverage from their insurers or on the state's health care exchange. Users say the exchange is still experiencing technical difficulties.
The law's supporters say these people will get more comprehensive policies with guaranteed benefits and protections — some that they might not have known they were living without — such as prescription drug coverage, no lifetime limits and no-cost preventive care.
But since they also include such benefits as maternity care, some critics say they can make the plans more costly for people who don't need or want those benefits.
One insurer, Aetna Inc., won't be signing people up for new policies because it is no longer allowed to offer such insurance in Maryland since it is not participating in the state's exchange. The company, which acquired Coventry Health Care earlier this year, said it won't renew 12,622 policies next year. A spokesman said those policies probably would not have met the minimum coverage requirements.
Aetna advised customers losing coverage to go to the exchange or to another insurance carrier to find a policy that meets their needs.
"Unquestionably, what they will get now will offer better coverage," said Dr. Peter Beilenson, who runs Evergreen Health Cooperative Inc., a nonprofit health insurance provider with plans on the exchange. "For some, the plans may be more expensive, but for others, such as those with a pre-existing condition, it may be less because their pre-existing conditions can no longer be considered."
Evergreen plans to send a flier Monday to people who might be looking for new policies, specifically including those who may have lost their coverage, Beilenson said.
He said he believes that this group is largely middle income or higher and that many might not be eligible for subsidies. They might be self-employed people who want a plan that has low premiums, high deductibles and not a lot of benefits, but offers protection in case of a catastrophic illness or accident.
Under the federal health care law, insurers can no longer consider factors such as gender or a new illness, which sometimes caused rates on the market for individuals to jump at higher rates than those offered to big businesses, said Carolyn A. Quattrocki, executive director of the Governor's Office of Health Care Reform.
In the past, people lost these individual policies because they could not afford them or were dropped after they got sick. Other consumers discovered when they had an illness or accident that they did not have the coverage they thought.
"Important consumer protections are now in place," she said. "New plans won't have hidden gaps in coverage that consumers may not even have been aware of."
It is unclear how many people across the country are losing their policies now. About 14 million to 18 million people have coverage on the individual market, said David Hogberg, a senior fellow for health care policy at the conservative National Center for Public Policy Research.
He said surveys show at least half the policies on the individual market do not meet the law's requirements.
"It's going to be a lot of people," he said. "Some may get policies that cost less because they have a pre-existing condition, but maybe not. More people are likely going to see an increase in their premiums on the exchange."
The loss of the unqualified insurance plans runs counter to the president's promises that no one would be forced to change their insurance plans. The president is adding caveats now that it is clear that several million Americans who buy insurance on the individual market might be forced to find new policies.
"What we said was, you could keep it if it hasn't changed since the law was passed," Obama told supporters Tuesday night.
The technical glitches on the exchange websites also left the White House in change-up mode. The president has shifted how he talks about the law, arguing that it's "more than a website" and focusing on not-yet-easily-accessible benefits offered under the law.
During a visit to Dallas on Wednesday, the president will go on offense, aides said, calling on Texas Gov. Rick Perry to accept federal Medicaid funding that would provide coverage for low-income people.
After that, Obama will turn to other topics on his agenda. White House events in the coming weeks will emphasize his immigration and economic plans.
White House officials say the president knows he cannot avoid the subject of Obamacare — and doesn't want to. But they say the president doesn't want technological troubles he can't control to consume the rest of his agenda.
On Tuesday, an administration official told lawmakers that the site's functionality was improving and was on track to be running smoothly for most users by the end of the month.
Initially overwhelmed by the volume of people trying to register, the federal site can now handle 17,000 registrants per hour — or five per second — "with almost no errors," testified Marilyn Tavenner, the head of the Centers for Medicare & Medicaid Services, before the Senate Health, Education and Labor and Pensions Committee.
Tavenner, whose agency oversaw the construction of the site, said her center has doubled the number of servers to meet demand and she rejected calls to redo the site from scratch.
"This is weeks, not months," she said about the timeline for improvements, "and we are not rewriting the architecture."
Such assertions have done little to quiet Republican critics. Rep. Darrell Issa, the California Republican who chairs the House Oversight and Government Reform Committee, released notes Tuesday from meetings of the administration's Obamacare "war room" that showed health department officials and contractors scrambling to fix the problems in the early days after the website's launch.
At one point, staff members realized that callers trying to sign up by phone were hearing advertisements for credit checks, because one of the healthcare.gov contractors also sells credit reports, according to the notes. At another, the Obama administration brought in consulting giant Booz Allen Hamilton to expand the website's help desk, "because we did not plan on having a large one."
The White House could deflect such stories with tales of successful enrollments, but the buggy website is complicating that strategy.
The president and aides have tried to answer the outcry about cancellation notices by noting that many of those consumers will be eligible for subsidies for comparable plans. But as long as consumers cannot easily verify that information on the healthcare.gov website, the argument is one that one White House official conceded was "only kind of persuasive."
Baltimore Sun reporter Eileen Ambrose and Kathleen Hennessey and Lisa Mascaro of Tribune's Washington Bureau contributed to this article.
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