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One Little Word

President Obama is being raked over the coals for misleading the public with his oft-repeated pledge that, under Obamacare, “If you like your health plan, you can keep it.”

Granted, for millions of people this pledge has proved false. But there is a difference between a lie, which is a deliberate attempt to mislead, and a misstatement, which is the inevitable human error of saying something that is not exactly what you meant to say.

The president and his apologists now assure us that if he ever made such a pledge, he simply misspoke. What he meant to say was, “If we like your health plan, you can keep it.” He was just off by one little word.

As presidential spokesman Jay Carney recently put it, the health care law bans “substandard policies that don’t provide minimum services,” by which he means 10 “essential” services that all non-grandfathered plans must cover as of 2014. One of those essential services is maternity care - an important benefit to be sure, but not one universally considered essential for all individual insurance customers. Men, for instance. And women past menopause. And prepubescent children. Also women who are absolutely certain they will not get pregnant or will not carry a pregnancy to term during the life of a typical 12-month insurance contract.

While the president does not seem to believe that his promises ought to be carved in stone, his administration treats so-called grandfathered plans, which can still be offered even though they do not meet Obamacare standards, as though they must be etched in granite. As the president himself said this week (in an appearance before his now-permanent campaign enterprise known as Organizing for Action), “what we said was you could keep it if it hasn’t changed since the law was passed.” All health plans must change periodically, to keep up with various regulatory requirements or to adjust co-payments and other financial terms. But Obama’s Health and Human Services department wrote regulations that say any such change eliminates the grandfathering protection that would have enabled consumers to keep the plans they had previously selected.

The president casts this as a benefit of his promise, not a caveat.

“Most people will be able to buy better plans for the same price or even cheaper than what they got before,” the president told his non-campaign staff at Organizing for Action. He was referring to the choices and subsidies that will be offered to Americans in 36 states via the HealthCare.gov website, when - and if - that site is made operational. “Now some Americans with higher incomes will pay more up front, for better insurance with better benefits and better protections that could eventually help them a lot.” So even if you lose the plan you like, and you have to pay more for a replacement, you should be grateful that Obamacare will prevent you from making other, less wise choices about your spending priorities.

Of course, not everyone is deeply attached to their particular health plan. I’d venture that most people, in fact, are perfectly willing to change their health care package, and even their insurance company, if they think they are getting a better deal. But a lot of people are deeply attached to their doctors.

Obama made a promise on that score, too. He pledged that the new law would allow Americans to keep their doctors. But many of the new health plans cover only services provided by doctors within a limited group, which may, but often will not, include the physicians customers want to use.

When the dust eventually settles over the wreckage of the HealthCare.gov vehicle, and when people get past the fact that the health plans they have are not necessarily the health plans they will be allowed to keep, attention is ultimately going to shift to the law’s bigger and more fundamental flaws. In the interest of making some form of health insurance available to most Americans who previously lacked it, the new law makes a trade-off in the forms of higher costs (with the costs often initially masked behind elaborate government subsidies) and narrower choices - and, for many people, both.

That’s the thing about presidential promises: They often hinge on every single word. After all, the president never promised you a rose garden. He just makes promises in the Rose Garden.

See the difference?

Larry M. Elkin is the founder and president of Palisades Hudson, and is based out of Palisades Hudson’s Fort Lauderdale, Florida headquarters. He wrote several of the chapters in the firm’s book, Looking Ahead: Life, Family, Wealth and Business After 55. His contributions include Chapter 1, “Looking Ahead When Youth Is Behind Us” and Chapter 4, “The Family Business."

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