Yesterday, the Department of Health and Human services updated its so-called grandfather rules that exempt health insurance plans in existence before March 23, 2010 — the day the Affordable Care Act became law — from many of the new regulations, benefits standards and consumer protections that new plans now have to abide by. The goal is to allow consumers to keep their existing plan, while also denying insurers and employers the ability to avoid the rules by dramatically cutting benefits, raising co-pays, or lowering employer contributions.

Under the original regulation only self-funded plans could “change third-party administrators without necessarily losing their grandfathered plan status.” Yesterday’s update, “allows all group health plans to switch insurance companies and shop for the same coverage at a lower cost while maintaining their grandfathered status, so long as the structure of the coverage doesn’t violate one of the other rules for maintaining grandfathered plan status”:

The Departments received many comments on the provision in the original grandfather rule stating that a group health plan would relinquish grandfather status if it changed issuers or policies. This change was made in response to those comments for the following reasons:

1. There are circumstances where a group health plan may need to make administrative changes that don’t affect the benefits or costs of a plan.

2. Comments expressed concern that the original provision could have the inadvertent effect of interfering with health care cost containment.

The new, looser rules will help a relatively small number of employers hang on to their grandfather protections longer, even if it won’t please Republicans (who tried to repeal these regulations back in September). But of course, eventually, most plans will lose their so-called ‘grandfather protections.’ And that’s a good thing. The whole point of grandfather rules is to serve as a bridge to gradually moving everyone into plans that have the kind of consumer protections and benefit standards that Americans say they want. By 2014 almost all plans will be in full compliance and we’ll hopefully have a health care system in which all plans are required to meet a basic floor of standards.

The Plum Line’s Greg Sargent pulls out the following quote from Richard Wolffe’s new book, which suggests that the Republicans — namely Senate Finance Committee Ranking Member and ‘gang of six’ attendee Sen. Chuck Grassley (R-IA) — were never serious about compromising with Democrats on health care reform. The following conversations occurred during the summer of 2009, possibly days before Grassley went home to Iowa and claimed that health reform contained death panels:

Just before [Grassley] returned to Iowa, he met with DeParle for another strategy session.

“If we do everything and resolve all the policy issues the way you want, with no public plan, do you think you’ll be able to support the bill?”

Grassley looked away. “I don’t know.”

Grassley went to the Oval Office for a similar conversation with the president and his fellow Republican and Democratic negotiators. He asked Obama to say publicly that he would sign a bill without a public option of a government-run plan. Grassley believed this would be a reasonable, minimal demonstration of Obama’s desire for a bipartisan deal. But the president declined to confront his own party base so explicitly. Obama asked Grassley the same question DeParle had posed: With every concession he wanted, could he support the bill?

“Probably not.”

“Why not?” asked an exasperated Obama.

“Because I’d have to have a number of Republicans,” said Grassley. “I’m not going to be the third of three Republicans. I’ve defined a bipartisan bill as broad-based support.”

Indeed, Grassley had said in June and then again in July that reform “ought to be from 80 people in the center of the Senate, I would think.”

Throughout the summer of 2009, he went to such great lengths to discredit and misrepresent health reform that many progressive advocates began to have doubts about his commitment to the effort. Here on the Wonk Room, I started something called ‘Grassley Watch‘ a tongue-in-cheek feature dedicated to tracking Grassley’s distortions. We compiled a document of Grassley’s most flamboyant attacks, hinting at the very thing that Wolffe is now reporting: rather than finding common ground with Democrats, Grassley was doing everything he could to obstruct and undermine consensus.

Below is a sampling of his greatest hits:

- Claims He Won’t Vote For ‘Imperfect’ Health Care Bill: “Now is the time to do this right or not do it.”…”We need to slow down and do a little less,” Mr. Grassley told another town-hall gathering in Pocahontas, Iowa, Monday afternoon. “We need to fix what’s broken and leave alone what’s working well.” In an interview, he vowed not to vote for an “imperfect bill” that includes a public option or gives the government too much control over end-of-life issues. [WSJ, 8/25/2009]

- Government Will Pull Plug On Grandma: “There is some fear because in the House bill, there is counseling for end-of-life, And from that standpoint, you have every right to fear….We should not have a government program that determines if you’re going to pull the plug on grandma.” [8/12/2009]

- Sends Fundraiser To Defeat ObamaCare: “I’m sure you’ve been following this issue closely. If the legislation sponsored by Speaker Nancy Pelosi in the House of Representatives and Chairman Ted Kennedy in the Senate is passed it would be a pathway to a government takeover of the health care system. lt would turn over control of your health care decisions to a federal bureaucrat … and take it away from you and your personal physician. It would mean government rationing in the name of cost controls. [Letter, 8/09/2009]

- Uses Kennedy’s Brain Tumor To Spread Fear Of Rationing: “I’ve been told that the brain tumor that Sen. Kennedy has — because he’s 77 years old — would not be treated the way it’s treated in the United States. In other words, he would not get the care he gets here because of his age.” [8/5/2009]

- Reform Will Place Bureaucrats In Charge: “PTL BluDogs Keep barkin Pelosie bill is Govt takeovr of healthCare Breaks Obama promise”keep what u hv” Puts Wash Burocrats in chrg MUSTSTOP.” [@ChurckGrassley, 7/24/2009]

- Proud To Obstruct Health Reform: “I take pride with being an obstructionist,” he said, if that means scuttling a public option that could lead to a single-payer system. [7/6/2009]

- Bipartisanship Means ‘No Public Option’: Asked “what needs to be in” a health care reform bill “for it to be bipartisan,” Grassley declared, “We need to make sure that there’s no public option.” [6/24/2009]

- Nonsensically Attacking Obama: “Pres Obama while u sightseeing in Paris u said ‘time to delvr on health care’ When you are “hammer” u think everything is NAIL I’m no NAIL.” [@ChuckGrassley, 6/7/2009]

At some point during that summer, Grassley also abandoned his past support for the individual health insurance mandate. During his re-election bid, Grassley claimed that he changed his mind about requiring Americans to buy health insurance in April or May of 2009, but that’s just not true. In August of 2009, Grassley was asked, “how does this bipartisan group that you`re a member of get to more health insurance coverage if you don`t mandate that employers provide coverage.” He replied, “through an individual mandate and that`s individual responsibility and even Republicans believe in individual responsibility.” Here he is expressing that very belief in June of 2009 on Fox News Sunday.

Sam Stein notes that a new Government Accountability Office (GAO) report has found that the Affordable Care Act — the very same law that supposed deficit hawks want to repeal — will lead to a “notable improvement in the long-term outlook under the Baseline Extended simulation” once fully implemented:

Both of these simulations incorporate effects of health care legislation enacted in March 2010, which includes a number of provisions to control the growth of federal health care spending. There is a notable improvement in the long-term outlook under the Baseline Extended simulation [that follows the CBO August 2010 baseline estimates for the first 10 years and then simply holds revenue and spending constant as a share of GDP] which assumes full implementation and effectiveness of cost control provisions, although some—including the Trustees, CBO and the CMS Actuary—have raised questions about the sustainability of certain of these cost controls.

These reports point to the biggest problem for repeal advocates: how to make up for the budget hole repeal will leave behind. So far, the GOP has handled the problem by simply dismissing the cost estimates. “Well, the assumptions are all wrong,” Minority Leader Mitch McConnell (R-KY) told CNN’s John King when pressed on the matter. “Nobody seriously believes the health care bill is actually going to save money. Nobody believes that,” McConnell insisted.

But the GAO, the CBO, and the CMS do and McConnell and the GOP will have to live by their rules if they hope to accomplish anything serious. Their dismissiveness, of course, suggests that they don’t and won’t.

Significantly, the report also notes that while reform helps control spending, it doesn’t do enough. “[E]ven under the more optimistic Baseline Extended scenario, which assumes the full implementation and effectiveness of cost control provisions, debt grows continuously over the long term indicating that more needs to be done,” it notes.

Last night, Politico’s Glenn Thrush reported on a curious incident in which Representative-elect Andy Harris (R-MD), a Republican freshman elected to Congress on his promise fight “government-run or government-mandated insurance,” “surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in.”

According to aides in the room, Harris “stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care.” Harris then asked if he could “purchase insurance from the government to cover the gap,’ added the aide, who was struck by the similarity to Harris’s request and the public option he denounced as a gateway to socialized medicine.”

This morning, MSNBC’s Joe Scarborough teased Harris for “bitching about not getting his government-run health care for a month”:

SCARBOROUGH: Seriously? If you had to talk about that, go whisper to the House administrator. And by the way, I think he’s a doctor? He says, ‘what do I do?’ COBRA, it’s called COBRA, for three weeks. You’ll get over it, dude. I mean, come’n man! Can you believe that?

‘No, the federal government should not be in charge of our health care? No, it’s socialism when the federal government is in charge of our health care! My hair is on fire! Oh, oh, oh, oh!’

Where is my government run health care? Seriously? So I guess he was against government-run health care before he was for it. Or maybe he’s just saying that Congressmen should have it, but working-class people shouldn’t? I’m so confused!

Watch it:

On his campaign website, Harris explains, “[a]s a physician, I know that our health insurance system is in need of repair. However, the answer to the ever-rising cost of insurance is not the expansion of government-run or government-mandated insurance but, instead, common-sense market based solutions that ensure decisions are made by patients and their doctors.”

During an event at the Cecil County Patriots Candidate Forum in February 2010, Harris claimed “there is no constitutionality mandated role for the federal government in health care,” and criticized the Medicare and Medicaid programs. Turning his attention to the health care reform legislation then moving through Congress, he described the public option as “a terrible idea,” adding, “you can’t have government-run health care, it’s just not right.” In July of 2009, Harris also appeared on Fox Business and warned viewers that if health reform passes, “we’ll look like Canada and England.” “Americans are not going to tolerate a bureaucrat making a decision for their families medicare care,” he said.

Ironically, in an interview with a local FOX affiliate just days before the election, Harris accused his opponent — incumbent Rep. Frank Kratovil (D-MD) who voted against the Affordable Care Act — of being “for it before he was against it, before he was for it, before he was against it.”