HEALTH AND HUMAN SERVICES SECRETARY KATHLEEN SEBELIUS: "The big employers are already in the market. Their plans won't change, and actually that's one thing that we need to remind everybody. If you have insurance with your employer that you like, if it works for you, if your employer is a state or city government, a large employer, if you're in Medicare, if you have veteran's benefits, your patient protections are already in place. Nothing changes in this new market." â¿¿ CNN, Thursday.THE FACTS: McCarthy is correct, Obama said exactly that. It was an empty promise, made repeatedly. Sebelius picks her words more carefully but still offers misleading assurances. Nothing in the health care law guarantees that people can keep the health insurance they already have. Costs can rise, benefits can change and employers can drop coverage. Insurance policies that are offered must now meet minimum standards, covering more preventive services, for example, and larger employers that don't offer insurance to workers will face penalties when that provision of the law, delayed by Obama, comes into effect. But that doesn't mean the status quo goes on for those who like what they've got now. Some larger companies are already curtailing their coverage to avoid taxes that start in 2018 on high-value plans, those worth $10,200 or more for individual coverage and $27,500 for family policies. The AFL-CIO, whose member unions had supported the law, now says it is being implemented in a way that is "highly disruptive" to some union health plans, driving up costs for these plans to a point that workers and companies must abandon them. Continuing a long-term trend, many companies are shifting more costs to employees through higher premiums, deductibles and copayments. Sebelius is on firm ground in stating that "your patient protections are already in place" because the law contains a range of new protections against lifetime caps on benefits, overly discriminatory pricing and more. But "nothing changes" for those with good insurance? Not so. The landscape is already shifting.