I Suppose This Explains It

So, I was reviewing my upcoming open enrollment changes and noticed that, other than my yearly outlay for coverage going up nearly $2500, our coverage plan was essentially the same as last year. Given the prior year-to-year change that doubled the co-pay on prescription meds and office visits, I was expecting more of the same, this year. Turns out that, contrary to the gushy email that HR sent out, the realities for why there were no similar changes this year are as much due to good plan performance the prior year as they were an effort to avoid having to implement new Obamacare provisions:

...plans will lose their "grandfather" status if insurers significantly cut benefits or increase out-of-pocket spending. Plans that lose this status will have to apply all of the changes required by the law.

In other words, had my employer actually bumped my co-pays up, they'd likely have lost their grandfather status. This would have put them on the hook for even more drastic healthcare related funding requirements:

• Free preventive care: eliminating co-payments and co-insurance in 2011 for preventive services.
• Unrestricted doctor choice: essentially eliminating the requirement for pre-auth or referral for use of services such as pediatrics, OBGYN, etc.
• Level charges for emergency services: The new health law requires that insurers remove prior authorizations for ER services. Also, insurers cannot charge higher co-payments or co-insurance for out-of-network providers for an ER visit
• Cover dependents until age 26: The legislation mandates that insurers will have to provide dependent coverage up to age 26 for all individual and group policies.
• Patient-friendly appeals process: In other words, for grandfathered plans, treatment appeals will still, heavily favor the insurer/employer rather than the insured.

So long as they're able to keep the plans fairly static and still have them "affordable enough" for employees to continue to participate, they're golden. They get to keep things as they always were - even as they add new employees. I imagine many other employers are doing likewise and will do so until such time as it's more advantageous to dump us all out into public care plans. All the while, the backers of Obamacare can keep a straight face when they say that they've made changes for the better (even if only in theory, not practice)