President Barack Obama seems to leave little room for doubt when he promises that his health care plan will let people keep the coverage they have. His vow sounds reassuring and gets applause, but no president could guarantee such a pledge.
Employers sponsor coverage for most families, and Obama's plan still leaves companies free to change their health plans in ways that workers may not like. Employers can even drop insurance altogether.
"No matter how we reform health care, we will keep this promise to the American people," Obama said Monday, addressing the American Medical Association. "If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."
He didn't let up.
"If you like what you're getting, keep it," Obama said. "Nobody is forcing you to shift."
Yet the legislation the Obama administration is working on with the Democratic-controlled Congress would make major changes in how Americans pay for health care. The goal is to slow cost increases and bring in nearly 50 million uninsured, and the consequences are bound to affect how employers design benefit plans.
Americans could be headed for a frugal era in which doctors order fewer tests and procedures and insurers monitor medical decisions more closely.
Few are predicting a stampede by employers — especially major companies — to drop coverage. But some just might, to avoid the hassle of dealing with insurance companies, and take advantage of the fact that workers could find coverage now with government help.
Earlier this week, a preliminary analysis by Congressional Budget Office estimated that 10 million people would have to seek new insurance under a Democratic plan that a Senate committee is working on, because their employers would no longer offer coverage. Those workers and their families would shop for a plan through new insurance purchasing pools called exchanges. About 160 million to 170 million people now get employer coverage.
In the meantime, William Warren provides some appropriate, and related, gallows humor: