Most health plans flunk Obamacare standards

/, Obamacare - Health Care Reform/Most health plans flunk Obamacare standards

You may recall when President Obama promised: “If you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you.” It seems that the Affordable Care Act’s experts didn’t quite get that part of the message.

Recent studies show that “less than 2% of the existing health plans in the individual market today provide all of the Essential Health Benefits required under the Affordable Care Act.” Another government study assessed that for some essential health benefits, only 5% of small group plans meet the standards.”

EHB coverage national

State averages of Essential Health Benefits (EHB) coverage in existing health insurance plans. Photo and study credit to

Furthermore, the average health plan currently meets only 76% of the mandatory essential benefits–which means we can expect nearly every plan on the market to change in response to Health Care Reform. In Michigan, the average plan covers 70-79% of Essential Health Benefits. In response to the new law, Blue Cross Blue Shield of Michigan plans to file all new certificates and riders to include the requirements. After 2013, BCBSM and BCN say that all existing products will be discontinued and only reform-compliant plans will be offered. Change is imminent.

Certainly other major carriers in Michigan and throughout the country will  follow suit in order to streamline their product portfolio and remain compliant. The complexity of the market and new regulations under the ACA make having the right benefits adviser as crucial as ever.


So back to the question, “If I like my plan, can I keep my plan?”

Not exactly….


“98 Percent of Individual Health Plans Flunk Obamacare Standards,” Forbes, Mar.12,2013.

Austin Financial Group is Michigan’s premier employee benefits firm. We help organizations that are concerned about their ability to offer a comprehensive benefits package in light of significant industry changes and Health Care Reform. Do you have the right benefits advisor? Contact Dean Austin or Lauren Simonetti today at 248.594.5550.