Health insurance stays in place under reform proposals

Seeking to jump-start efforts to pass a health care bill, President Barack Obama defended his reform plan in a speech to a joint session of Congress.

He sought to reassure Americans they would not lose their current coverage.

"First, if you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have," Obama said. "Let me repeat this: Nothing in our plan requires you to change what you have."

Obama is correct that the plans under consideration do not force those who currently have insurance to change plans. The proposals seek to build on the current system, where many Americans get coverage through work.

The plans do, however, implement new consumer protections and introduce new ways of regulating health insurance companies.

These new rules will surely change the current health care system. The bill in the House of Representatives gives employer-provided insurance five years to come into compliance with new rules, such as caps on out-of-pocket expenses and coverage for preventive care.

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Right now, employers have the freedom to change or drop coverage, and they will continue to have that freedom under health reform. Doctors, too, can opt in or out of accepting various insurance plans, including Medicare. Because of this inherent instability to the health care system, and because of the new regulations, we rated one of Obama's earlier statements on the effects of reform — "If you like your health care plan, you can keep your health care plan" — Half True .

Given what we know about reform, it seems likely that at least some people will have employers who decide to change plans when insurers alter their offerings under the new regulations. This would be most likely for any small businesses that currently offer health insurance. They will be allowed to use a national exchange where insurers compete to offer insurance, and prices are expected to be lower.

Obama's statement from the speech is more carefully phrased than his earlier statement. In his speech, he said that if you are "already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have." That is true, there is nothing in the plan that proactively forces these kinds of changes, and the bills clearly intend to leave much of the current health care system in place. We rate Obama's statement True.