By Aamer Madhani and Ron Barnett, USA TODAY
Cathy Pedersen is in what amounts to health insurance limbo.
When President Obama announced a rule change last week to his Affordable Care Act that potentially would allow hundreds of thousands of Americans to keep their old insurance plans, Pedersen saw a glimmer of hope that the inexpensive, high-deductible plan she's been purchasing for nearly 20 years wouldn't be canceled after all.
Soon after Obama announced the rule change, Pederson of Gilbert, Ariz., made a quick call to Blue Cross Blue Shield of Arizona to see if she could get back her old plan, which did not meet ACA minimum requirements.
She was told by a customer service representative that the insurer was still consulting with Arizona's insurance commission on whether it will make her 2013 plan available again after it expires Dec. 31.
"I cannot afford to pay $200 more per month," said Pedersen, 54, who added that the cheapest alternative policy she's found with the newly established federal government exchange would more than double the $186 monthly premium she paid in 2013. "We're more than halfway into November, and my insurance broker is telling me it takes up to 45 days to get on a plan. I just feel like this situation did not have to happen."
In addition to Obama's proposed administrative fix, the GOP-led House approved legislation Friday - which has little chance of becoming law - that would allow insurers to continue offering health care plans to new and existing customers through next year, even if the plans do not meet the minimum benefit requirements.
The true battle of whether Americans such as Pedersen will be able keep their policies next year will largely be fought on the state level in the days ahead. Many who received cancellation notices and have shopped for new coverage must calculate whether they are better off sticking with what they have or trying to get back on their old plans.
The health insurance market is regulated by states, and insurance commissioners who have spoken out on Obama's proposed fix have been split on whether they will make any changes to accommodate the president's rule change.
Obama met with executives from 15 leading insurance companies Friday and encouraged them to support his administrative fix, which is meant to address the problem of mass cancellations of policies despite his oft-repeated promise that Americans would be able to keep their insurance policies if they liked them.
Industry analysts say Obama is putting insurers in a bind and it may not be practical for insurers to rescind cancellations. Under the law, to have coverage take effect by Jan. 1, the consumers must make their coverage elections by Dec. 15.
Insurers are essentially being given a month to reprogram their computer systems for policies, rates and eligibility; mail notices to the policyholders that describe just what the differences are between the grandfathered policies and the ACA compliant plans; request and receive the consumers' decisions; then enter those decisions back into their systems, said Robert Laszewski, an analyst with Health Policy and Strategy Associates
"They (the White House) appear to be throwing this hot potato into the hands of the insurance industry, who will now be on the hot seat to agree to do the impossible or take the heat for failing to do so," Laszewski said
Kathleen Forster, 64, a retired interior designer in Grosse Point, Mich., who received a cancellation notice in the mail several weeks ago, said she holds no hope that her provider, Blue Cross Blue Shield of Michigan, will rescind the cancellation notice it sent her and her husband several weeks ago.
"Why would they?" Forster said. "They jumped through all these hoops to come up with something new. Now they are going to rescind that? To make President Obama look good?"
The Forsters ended up buying a new policy from Blue Cross that meets the ACA requirements. Their premium ticked up from $762 per month to $820; their deductible shot up from $1,000 to $12,000.
Others who received cancellation notices say they won't go back to the individual insurance market.
Ginger Culbertson, 61, a self-employed marriage and family therapist in Greenville, S.C., said it took her nearly a month and a half - with the help of a private insurance broker - to navigate her way through HealthCare.Gov.
As frustrating as the process was, she made the switch. Under her current policy, she pays a $783 monthly premium and has a $5,000 deductible. She cut her premium by more than half, and her deductible will be $3,500. She also qualified for a tax credit.
"I'll be way better off than I am right now," she said.
Rocco Racano of Marlboro, N.J., said the option to keep his former policy wasn't appealing.
He previously had a policy from Horizon Blue Cross Blue Shield of New Jersey for adults ages 60-65 that covered him and his wife. It cost $1,020 a month. It had a $40 co-pay and a $2,500 family deductible. And it had an out-of-pocket maximum of $6,500.
The Newark-based insurance company canceled the policy, set to expire next June.
Racano said a gold plan offered by Horizon in the health exchange had a $908-a-month premium and a $3,000 deductible. His household income is low enough that he could receive a subsidy of about $500 a month.
Still, Racano said he isn't sure how it will play out. He couldn't get on the government's health care website and had to apply by mail instead. He hasn't received a response.
Jason Cannon, 33, a writer from Birmingham, Ala., said he and his family lost the Blue Cross Blue Shield of Alabama plan that cost him $307 per month and had a $1,200 premium. His plan did not meet the ACA minimum benefit requirement.
He has since found a similar plan with UnitedHealthCare that will cost him $330 per month. Cannon took particular umbrage with the ACA requirement that plans cover maternity care - something his old plan did not include.
"If I choose to bet on myself (on a plan with a lower premium/higher deductible), I should be allowed," Cannon wrote in an e-mail. "I know my medical history, my income level and have assigned a risk value based on that. The government essentially took none of that into account, forced me to bet on getting or being sick (and possibly becoming pregnant). That inflated my premium for a newer policy with a higher level of coverage I don't necessarily need."
Cannon said his wife called Blue Cross Blue Shield on Thursday after Obama announced his fix to see if their 2013 policy would be available. But ultimately, Cannon said he didn't think his family will go back to the old plan.
"I would argue this is no fix at all," Cannon said. "If I were an insurer, why would I go back to all the customers whom I have notified were losing their policy and tell them, 'No, you can stay. But we'll send you another letter in a year.'"
Contributing: Dennis Wagner of The Arizona Republic, Todd Spangler of the Detroit Free Press and Michael Diamond of the Asbury Park Press. Barnett reports for The Greenville (S.C.) News.