Obamacare Q&A: Keeping old policies, and why abortion coverage costs some people $1

In this installment of The Mirror’s Obamacare Q&As, we’ll address what happens to the old insurance plans people tried to hang onto last year and how federal law on funding for abortions means that some Connecticut residents pay small bills to their insurers.

Have a question about Obamacare? You can email Mirror health care reporter Arielle Levin Becker at alevinbecker@ctmirror.org.

My insurance plan doesn’t comply with Obamacare, but I was able to keep it this year because I renewed it at the end of 2013. Can I renew it again so I don’t have to find another plan?

No. In fact, more than 50,000 Connecticut residents have health plans that they won’t be able to keep past this year because they don’t meet the requirements of the Affordable Care Act.

States had the option of allowing people to keep insurance plans that don’t comply with the health law, but Connecticut decided not to do so.

You probably remember the big debate about canceled policies last year. Because Obamacare placed new requirements on health plans, insurance companies notified customers last fall that their policies didn’t comply with the law and would be discontinued. That prompted an outcry from people who had heard President Obama repeatedly pledge that people who liked their plans could keep them.

Obama responded by giving states the option of allowing insurance companies to renew policies that didn’t comply with the health law. Gov. Dannel P. Malloy decided not to allow it, saying that insurance companies did not plan to extend the policies anyway and that if the plans were extended, they would likely come with significant rate hikes.

But many people managed to avoid having to give up their old plans by renewing them early, before the new insurance rules took effect on Jan. 1. Other people bought new policies at the end of 2013 to avoid having to buy plans that met the new requirements, which generally cost more.

At the time, the expectation was that it was a 12-month reprieve, and that people would have to buy new plans when those expired. But earlier this year, the federal government announced that people would be allowed to keep their noncompliant plans for another two years, if their states and insurers allowed it.

But the Connecticut Insurance Department and the Malloy administration decided against allowing people to extend their noncompliant plays beyond 2014. The reasoning, according to a department spokeswoman, is that since no new members can join the noncompliant plans, the risk pools will continue to shrink, likely leading those who have the policies to face higher premiums.

The department is allowing people who bought their plans in December 2013 to continue them through the end of the year, if the carriers allow it, to avoid having to buy a new plan for the month between when the old plans are set to expire and when new plans take effect Jan. 1.

Things are different for people who have old plans that are considered grandfathered — that is, plans that were purchased before the health law passed in 2010 and have not changed substantially since then. Even so, insurance companies can decide to stop offering grandfathered plans, so if you have one and want to keep it, it depends whether your insurer will allow it.

I qualified for a free insurance plan under Obamacare, but I still have to pay my insurance company a small amount each month. Why is that?

It’s because of federal restrictions on paying for abortion coverage and the insurance company’s choice to offer it.

Under Obamacare, people with low or moderate incomes can receive federal financial assistance to discount their insurance premiums. For some people, the amount of the federal subsidy exceeds the cost of the premium, allowing them to receive coverage without having to pay any monthly fee.

So why is it not entirely free? By law, federal money can’t be used to pay for coverage of elective abortions. That means that if an insurance plan covers elective abortions, the money to cover that benefit can’t come from the federal government.

For people who pay all or a portion of their own premiums, that abortion fee comes out of their contribution. But if the federal government is funding someone’s entire premium, there’s an issue.

As a result, people who don’t pay any premium for their coverage must pay for the abortion coverage out of their own pockets. Each insurer determines how much money it needs from each member to cover elective abortions, and is supposed to keep that amount in a separate account to pay for the coverage, said Chad Brooker, policy analyst for Access Health CT, the state’s health insurance exchange.

For ConnectiCare Benefits and HealthyCT, the fee is $1 per month. Anthem Blue Cross and Blue Shield charges a percentage of people’s premiums, so the amount varies.

Insurance companies that sell plans on the exchange had the choice of whether to cover elective abortions, and all chose to do so, Brooker said.

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