Some news reports and conservative blogs have characterized the government’s new regulations about how insurers can preserve their so-called “grandfathered status” — under which they will be exempt from some of the law’s benefit standards and regulations — as a departure from President Obama’s promise that if you like the coverage you have, you can keep it:

- NY POST: Bottom line: Sebelius means to dictate what your insurance plan must look like almost from day one, no matter how you get your coverage.

- HOT AIR: Their strategy for letting you keep your plan if you like your plan is to include a “grandfather clause” that would exempt current plans from consumer protection requirements so long as copayments and deductibles are below certain limits. The problem: If your insurer alters the terms of the plan in the normal course of business and those limits are crossed, it’s no longer a grandfathered plan and the new consumer-protection benefits suddenly become mandatory — which means an exciting new monthly premium when your insurer inevitably passes the costs of those benefits on.

- INVESTORS BUSINESS DAILY: Internal administration documents reveal that up to 51% of employers may have to relinquish their current health care coverage because of ObamaCare. Small firms will be even likelier to lose existing plans.

If you’re “keeping a plan you like,” you like it because you believe it works. It offers the right benefits for the right price. If employers or insurers violate the grandfather protocols, they’re either slashing your benefits or jacking up your deductibles or co-payments. They’re tipping the balance in the cost-to-benefit ratio and selling you a faulty product; you’ll pay dearly once you need to actually use the coverage you thought you liked.

In the same way that the government requires automakers to meet certain safety standards and design specifications, insurance issuers and employers will have to abide by new benefit and consumer protection minimums. They shield consumers from drastic benefit cuts or cost shifts. And by discouraging insurers and employers from making these changes, the new grandfather regulations help you like what you have.

The new health care law grandfathered health plans in existence before March 23, 2010 — the day reform became law — and exempted existing plans from many of the new regulations, benefits standards and consumer protections. But the exclusion comes with conditions. If the plans make changes that undermine the spirit of the health law and significantly burden enrollees with lower benefits and increased costs, they have to come into compliance with all reform provisions.

Today, as HHS, Treasury and Labor unveil the new regulations, the NYT’s Robert Pear offers this preview:

- Insurers will lose their grandfathered status if they cancel coverage when a person becomes ill or impose lifetime limits on benefits.

- Insurers will lose their grandfathered status if they eliminate all benefits for a particular condition or if it increases deductibles or co-payments by more than the rate of medical inflation plus 15 percentage points.

- Insurers will lose their grandfathered status if an employer reduces its contribution so that its share of the total cost of coverage declines by more than 5 percentage points.

- Insurers will lose their grandfathered status if they increase co-payments for doctor’s visits to $45, from $30 — a 50 percent increase — while medical inflation was 8 percent.

- Insurers will lose their grandfathered status if they increase the amount consumers to pay as percentage of the bill.

- Insurers will lose their grandfathered status if they reduce the cap for covered services each year.

If these rules sounds like good things for consumers, it’s because the government is trying to discourage insurers from reducing health care benefits and increasing costs. Ultimately, the goal of reform is to phase down the number of insurers protected under the grandfathered provisions and bring all plans in compliance with the new rules and regulations. It’s in the government’s interest to prevent insurers from using the two different sets of rules to segment “good” and “bad” risks (that could result in higher costs for older and less healthy enrollees) and free itself from the burden of having to maintain and enforce two separate regulatory systems — one for grandfathered plans and one for plans issued after March 23, 2010.

I’ve been worried that the state-based nature of health care reform — states are responsible for managing and regulating the exchanges and implementing many other consumer protections — would allow the many states that are suing the federal government over the constitutionality of the law to drag their feet in implementing the measure. Jake Grovum’s article about how anti-health care crusaders across America are reluctantly implementing the measure, doesn’t necessarily dismiss my concerns, but it at least tempers them. From Grovum’s piece:

Yet even in Texas, hollers of protest are giving way to the blunt reality of governing, as the state takes reluctant but real steps toward implementing the law. Already, Texas has developed a plan for adding Medicaid coverage for services at freestanding birth centers, an early requirement of the law. More broadly, Department of Insurance and Medicaid officials have begun working on the two biggest parts of the law for states: expanding Medicaid access and tightening regulation of insurers.

Similar scenarios are playing out across the country, where every state that’s actively challenging the law is at the same time taking steps to implement it, according to a Stateline analysis and information compiled by the National Conference of State Legislatures. Just like the states that supported the overhaul, opposition states are setting up high-risk insurance pools and setting up task forces to plan out how to meet an aggressive set of deadlines spelled out in the law. While some people see these steps as acknowledging the lawsuits’ slim chances of success, others simply see them as a smart backup plan.

I suspect that part of the reason for this dynamic is that the health care reform is actually a pretty good deal for states. Away from the cable news mics and the reelection press releases, governors stop acting like politicians and start acting like public officials. They have to realize that covering hundreds of thousands of new residents on the federal government’s dime is a cost effective strategy, particularly since it saves the states money on uncompensated care and other health expenses. The other possible factor is that unelected public officials who are responsible for dealing with the very pronounced health crisis of states like Texas and Nevada are undoubtedly pushing along the implementation process.