Nationally a considerable number of people could be affected by cancellations. Information from insurers is still dribbling in to state regulators.
In Washington state, the changes will affect more than 400,000 people, said Stephanie Marquis, spokeswoman for insurance commissioner Mike Kreidler. Marquis said she expects the premiums for replacement plans to be similar to current ones, but with better coverage.
"Your costs involve more than your premiums," Marquis explained. "It's also what you would have to pay out of pocket if you had actually used your health plan."
Others see an encroaching nanny state.
"You're going to be forcibly upgraded," said Bob Laszewski, a health care industry consultant. "It's like showing up at the airline counter and being told, `You have no choice, $300 please. You're getting a first-class ticket, why are you complaining?'<!p><#148>
Obama's promise dates back to June of 2009, when Congress was starting to grapple with overhauling the health care system to cover uninsured Americans. Later that summer, public anxieties about changes would erupt at dozens of angry congressional town hall meetings with constituents.
"If you like your health care plan, you'll be able to keep your health care plan, period," the president reassured the American Medical Association. "No one will take it away, no matter what."
At the time, some saw the promise as too broad, given that health plans are constantly being changed by the employers that sponsor them or by insurers directly.
Nonetheless, Democrats in Congress devised a complicated scheme called "grandfathering" to try to deliver on Obama's pledge. It can shield plans from many of the law's requirements, provided the plans themselves change little.
State officials said it has proven impractical in most cases for insurers to "grandfather" plans sold to individuals.
Questions and answers for Virginia insurers provided by state regulators say most carriers are expected to file new policies "given the extensive amount of changes resulting from state and federal laws."
A Washington state insurance department presentation for insurers says plans must mail their discontinuation and replacement notices to consumers by Sept. 15.
State insurance spokeswoman Marquis said, "I don't think it is necessarily a bad thing that they are going to be getting a replacement notice, because they going to be able to go out and shop in this marketplace and they'll be getting better coverage."