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A Project of The Annenberg Public Policy Center

Keeping Your Health Plan

Party Lines Insert BlueThe Line: If you like your health insurance plan, you can keep it.

The Party: Democratic

For years, President Obama promised millions of Americans with health insurance that “if you like your health care plan, you can keep your health care plan” under his health care overhaul. He wasn’t the only one, either.

Back in 2009, several top congressional Democrats echoed the president’s assurances that those who were happy with their plans would be able to keep them.

Senate Majority Leader Harry Reid said the health care overhaul efforts “means making sure you can keep your family’s doctor or keep your health care plan if you like it.”

Senate Majority Whip Dick Durbin told the happily insured “we are going to put in any legislation considered by the House and Senate the protection that you, as an individual, keep the health insurance you have, if that is what you want.”

And current Senate Budget Committee Chairwoman Patty Murray also said: “If you like what you have today, that will be what you have when this legislation is passed.”

But longtime readers of FactCheck.org know we’ve been writing since August 2009 that that promise simply couldn’t be made to everyone who already had health insurance.

That’s because most Americans are covered by plans through their jobs, and nothing in the health care law prohibited employers from dropping coverage or changing health plans as they have been able to previously. Before the health care bill even became law, the Congressional Budget Office projected that up to 10 million people who otherwise would have been covered by employer-provided plans would not be offered coverage under one Democratic proposal.

The health care law also sets minimum standards for insurance coverage, requiring that all health plans cover mental health benefits, prescription drug coverage, vaccinations, dental and vision care for children, maternity care for women, and more. The upgrades mean that some plans that were inexpensive for purchasers — but didn’t cover the required benefits — would eventually cease to exist.

Americans who purchase such plans on the individual insurance market have been receiving notices that their current plans will no longer be offered after this year, as several news organizations reported in October. Those notices make it clear that Obama was over-simplifying and over-promising when he kept saying, “if you like your health care plan, you can keep your health care plan.”

Obama, in a Nov. 4, 2013, speech, tried to explain his past promises by saying “what we said was you can keep it if it hasn’t changed since the law passed.” Asked when the president had previously included that detail, White House Press Secretary Jay Carney, in a Nov. 5 press briefing, said Obama was referring to the law’s clause allowing insurers and employers to “grandfather” plans offered before the bill became law.

“The president was referring to the law and to the fact that the law was written in a way — and everybody who closely covered the drafting of that legislation knew it was written about — that the grandfathering clause was in the law, and he was referring to the implementation of that law through the rule process,” Carney said.

Grandfathered health plans do not have to meet all of the law’s new coverage requirements. But in order to be grandfathered, health plans must have existed on March 23, 2010. Those with individual grandfathered plans had to have them before the law took effect. And to maintain their grandfathered status, the plans must not be changed to cut benefits or significantly raise prices for consumers through deductibles or co-pays.

It’s true that Health and Human Services Secretary Kathleen Sebelius explained the grandfather clause in a June 14, 2010, blog post announcing new health care regulations.

“Under the rule issued today, employers or issuers offering such coverage will have the flexibility of making reasonable changes without losing their ‘grandfathered’ status,” Sebelius wrote. “However, if health plans significantly raise co-payments or deductibles, or if they significantly reduce benefits – for example, if they stop covering treatment for a disease like HIV/AIDS or cystic fibrosis – they’ll lose their grandfathered status and their customers will get the same full set of consumer protections as new plans.”

Sebelius went on to say that the “bottom line is that under the Affordable Care Act, if you like your doctor and plan, you can keep them.” But that still wouldn’t be true for many, and Obama glossed over those details in his speeches. The president made the sweeping promise, in one variation or another, while the Affordable Care Act was being debated in Congress in 2009. He said it again after he signed the bill into law in 2010. And he continued to say it after the Supreme Court ruled the law was constitutional in 2012.

Even the president now acknowledges that his promise went too far.

In an interview with Chuck Todd of NBC News on Nov. 7, Obama offered an apology to the many Americans who have been notified that they are, in fact, losing the health plans they previously had and wanted to keep.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama said. “We’ve got to work hard to make sure that they know we hear them and that we’re going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

Strangely, the White House linked to the apology on a health care Web page that carried the same promise he now says went too far.

White House website, Nov. 11: If you like your plan you can keep it and you don’t have to change a thing due to the health care law.

— D’Angelo Gore

Here is a list of some who have promised individuals could keep their health plans:

Sen. Patty Murray of Washington, June 10, 2009: We here in the Senate are working on legislation that will protect people’s choice of doctors, will protect their choice of hospitals, will protect their choice of insurance plan. If you like what you have today, that will be what you have when this legislation is passed. (Source: Remarks on the Senate floor.)

Sen. Harry Reid of Nevada, July 28, 2009: The reform we are pursuing … not only means making sure you can keep your family’s doctor or keep your health care plan if you like it but also that you can afford to do so. (Source: Remarks on the Senate floor.)

Sen. Dick Durbin of Illinois, July 30, 2009: Many people say: I like my health insurance right now. I don’t want to change. I don’t want to go into Medicare or Medicaid. I like what I have. Would you please leave people alone. The answer is yes. In fact, we guarantee it. We are going to put in any legislation considered by the House and Senate the protection of you, as an individual, to keep the health insurance you have, if that is what you want. What we are trying to create are voluntary choices and opportunities. (Source: Remarks on the Senate floor.)

President Obama, Aug. 15, 2009: At the same time — I just want to be completely clear about this; I keep on saying this but somehow folks aren’t listening — if you like your health care plan, you keep your health care plan. Nobody is going to force you to leave your health care plan. (Source: Remarks from town hall on health care.)

Sen. Mark Begich of Alaska, Dec. 24, 2009: Alaskans who have health insurance now, and are happy with it, can keep it. (Source: Press release.)

President Obama, March 25, 2010: From this day forward, all of the cynics, all the naysayers — they’re going to have to confront the reality of what this reform is and what it isn’t. They’ll have to finally acknowledge this isn’t a government takeover of our health care system. They’ll see that if Americans like their doctor, they’ll be keeping their doctor. You like your plan? You’ll be keeping your plan. No one is taking that away from you. (Source: Remarks in Iowa City, Iowa.)

Sen. Max Baucus of Montana, Sept. 29, 2010: From the beginning, the law has been about preserving what is good about American health care. That is why one of the central promises of health care reform has been and is: If you like what you have, you can keep it. That is critically important. If a person has a plan,and he or she likes it, he or she can keep it. (Source: Remarks on the Senate floor.)

Sen. Carl Levin of Michigan, April 6, 2012: This bill will help make health insurance more secure for those who already have it and make coverage available for millions of uninsured Americans. And it is important to remember that for those who already have health insurance, the law allows you to keep your existing plan. (Source: Press release.)

President Obama, June 28, 2012: First, if you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance — this law will only make it more secure and more affordable. (Source: Remarks on Supreme Court ruling on the Affordable Care Act.)

Sen. Jeff Merkley of Oregon, web page accessed Nov. 11, 2013: If you like your current health insurance, you will be able to keep it. And you will be able to continue seeing your current doctor. Health care reform would simply give you the choice to change insurance providers if you so choose. (Source: Q & A webpage.)

Sen. Kay Hagan of North Carolina, fact sheet accessed Nov. 11, 2013: For middle class families, health care reform … Ensures you can keep the coverage you have and guarantees coverage if you change or lose your job. (Source: Fact sheet.)

White House web page, accessed Nov. 11, 2013: If you like your plan you can keep it and you don’t have to change a thing due to the health care law. The President addressed concerns from Americans who have received letters of policy cancellations or changes from their insurance companies in an interview with NBC News, watch the video or read a transcript. (Source: White House website.)