During debate leading to passage of the Patient Protection and Affordable Care Act (“Affordable Care Act” - ACA), President Obama stated: “we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you will be able to keep your health care plan, period.” However, recently, many people have received cancellation notices from their health plan or insurer, and some have found that available alternatives do not allow them to keep their physician. The Associated Press estimated on November 2 that at least 3.5 million Americans had received cancellation notices.
Given the incentives embedded in the ACA, it was actually quite predictable that many Americans would lose their health insurance. The ACA requires health plans and insurers in the group and individual markets to provide an “essential health benefits” package, prohibits them from excluding persons based on preexisting conditions, and prohibits them from basing premiums on health status. While the ACA allows health insurance that was in effect when the ACA was enacted (March 23, 2010) to be “grandfathered,” both the statute and implementing regulations impose criteria for grandfathered status that are difficult to meet.