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While marketing the Affordable Care Act, former President Barack Obama often said “If you like it, you can keep it.”, i.e. you would be able to keep your existing health insurance rather than having to shop for a plan on the exchange. This did not pan out initially, because while the bill had a grandfather clause that allowed existing health insurance plans to continue to operate, if a plan underwent significant changes the grandfather clause would no longer apply. This led to insurers canceling a small but appreciable number of individual and employee health insurance plans, since they found some plans unprofitable to continue to run without changes.

To address this issue, President Obama made an administrative fix, allowing grandfathered health insurance plans to continue to operate even if they had undergone changes, so long as state insurance commissioners allowed it:

Now, as I indicated earlier, I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked, they could keep it.  And to those Americans, I hear you loud and clear.  I said that I would do everything we can to fix this problem.  And today I'm offering an idea that will help do it.

Already, people who have plans that predate the Affordable Care Act can keep those plans if they haven’t changed.  That was already in the law.  That's what's called a grandfather clause.  It was included in the law.  Today, we're going to extend that principle both to people whose plans have changed since the law took effect, and to people who bought plans since the law took effect.

So state insurance commissioners still have the power to decide what plans can and can’t be sold in their states.  But the bottom line is, insurers can extend current plans that would otherwise be canceled into 2014, and Americans whose plans have been canceled can choose to re-enroll in the same kind of plan.

My question is, what became of this administrative fix? Did it help address the issue of plans getting canceled? A Politifact article written a month after the announcement said that only some state insurance commissioners allowed grandfathered plans to make changes:

Obama offered an administrative fix that same day, allowing state insurance commissioners to extend current plans. But only some have chosen to do so.

So how many state insurance commissioners ultimately decided to allow it? And is this administrative fix still in effect to this day?

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  • It would also be interesting to know if the canceled plans got reinstated after the fix. Sep 4, 2022 at 20:57
  • @NoDataDumpNoContribution: They didn't.
    – Joshua
    Aug 31 at 4:01

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Grandfathered plans were frozen, meaning, an individual or employer purchasing new healthcare after 2010, could not get them if they didn't already have them. An employer could add additional employees to the plan, so it is possible to enroll new people into the plan for an existing company that had a grandfathered plan before. However if the employer or insurer wants to change the plan details, the plan may not qualified for the grandfathered status.

This page has some references to what changes triggers an ended of grandfather status: https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/faqs-grandfathered-plans.aspx

This page indicates that there is at least one major insurer who still offers their customers a grandfathered plan (again only for customers that had the plan back in 2010, not new customers): https://www.uhone.com/resources/articles/health-and-wellness/current-golden-rule-grandfathered-and-non-grandfathered-health-plans-to-continue

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  • But my question is about former President Obama’s administrative fix, which allowed grandfathered plans to operate even if they did have significant changes, so long as state insurance commissioners were OK with it. I’d like to know what happened with that fix, like how many state insurance commissioners took Obama up on that, and whether the administrative fix is still in effect to this day. Sep 8, 2022 at 23:03
  • I do not believe that the fix was codified into any regulation. It was simply an informal delay of enforcement, that was extended for two years. there was no hhs rulemaking or executive orders made at that time regarding the fix.
    – toppk
    Sep 8, 2022 at 23:30

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