ND lawmakers question discontinued plans under Obamacare
BISMARCK – Questions about health insurance plans being discontinued under Obamacare dominated discussion about the Affordable Care Act on Tuesday at the Capitol, with one Republican lawmaker saying many people feel the law’s grandfather-clause exemption was “misrepresented at the highest levels.”
The Legislature’s Health Care Reform Review Committee heard from representatives of Blue Cross Blue Shield of North Dakota and Sanford Health Plan, both of which have been notifying customers that their plans are being canceled because they don’t meet the act’s new guidelines.
Insurance Commissioner Adam Hamm said information he requested last week from the state’s three major health insurers showed that 35,585 customers have been informed they will be losing their current plans: 31,600 from Blue Cross Blue Shield, 3,173 from Medica and 812 from Sanford Health Plan.
Luther Stueland, director of health policy impact and exchanges for Blue Cross Blue Shield, said most of its plans being discontinued were sold to new customers after the Affordable Care Act was signed into law on March 23, 2010, making them ineligible for the grandfather clause that allows customers to keep plans in place before that. Others lost their grandfathered status because of significant changes to their plans, he said.
About 70 percent of Blue Cross Blue Shield’s employer groups and 50 percent of its individual members remain on grandfathered plans, Stueland said.
The committee’s vice chairman, Sen. Spencer Berry, a Fargo doctor, said he didn’t believe that insurance companies maliciously sold policies they knew weren’t going to go forward, asking Stueland, “Was this something that just ended up being a catch-22?”
Stueland said Blue Cross Blue Shield knew about the grandfathering rules in the summer of 2010 but didn’t learn until later how other Obamacare factors, such as the essential benefits that determine basic health coverage and guidelines for out-of-pocket expenses, would affect customers’ plans.
“It’s kind of like the speed limit changed. Was the speed limit posted everywhere? Not really. And I think to the president’s assertion that, ‘If you like your health plan you can keep it, period,’ it was an attempt to simplify something that wasn’t a simple provision,” Stueland said.
Berry said the 8 percent of Blue Cross Blue Shield’s 400,000 North Dakota members having their plans discontinued shouldn’t be minimized.
“A lot of people felt it was misled or misrepresented at the highest levels,” he said.
Sen. Tim Mathern, D-Fargo, asked if there was a difference in how many health insurance plans would have undergone routine changes anyway without Obamacare, saying, “I’ve never been told in my life that you can just keep the same plan,” pay the same premium and receive the same benefits.
Sarah Delaney, associate actuary for Sanford Health Plan, said changes “would absolutely be happening. But she said insurers can’t offer the same plans that they could before Obamacare, and discontinuations notices wouldn’t have been issued.
Hamm reported that sign-up for the federal health insurance exchange in North Dakota as of Nov. 1 totaled 30 enrollments covering 37 people. The exchanges opened on Oct. 1, and North Dakota was one of 36 states that opted to allow the federal government to administer its exchange, a decision Hamm called the right one given the low enrollment so far and problems plaguing the healthcare.gov website.
Some Republicans are still holding out hope that Obamacare’s individual mandate requiring people to buy health insurance or pay a penalty can be delayed. Rep. Jim Kasper, R-Fargo, asked Hamm whether the state could order insurers to honor discontinued plans if Congress and President Obama were to agree to defer the mandate until the end of 2014. Hamm said yes, such a change in federal law or rules would apply in North Dakota and the state could order insurers to follow it.
Committee members also were updated Tuesday on the progress of Medicaid expansion in North Dakota under the Affordable Care Act.
The act required states to expand Medicaid coverage to eligible residents with incomes below 138 percent of the federal poverty line or face penalties. But a June 2012 ruling by the U.S. Supreme Court had the effect of giving states the option of expanding Medicaid.
North Dakota’s Department of Human Services is doing so, having received 214 applications for Medicaid expansion coverage as of Nov. 3, Executive Director Maggie Anderson said. In addition, 365 applications through the healthcare.gov website have been assessed as Medicaid-eligible, though not necessarily eligible for Medicaid expansion coverage, she said.
Anderson said the department hopes to award a contract to a vendor on Wednesday to begin processing the applications.
The deadline is Dec. 15 to apply for a Medicaid plan to be effective Jan. 1. Those who expect to be eligible are being directed to www.nd.gov/dhs or their local county social service office.
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