OBAMA ANNOUNCES CHANGE TO ADDRESS HEALTH INSURANCE CANCELLATIONS
Juliet Eilperin, Amy Goldstein and Lena H. Sun
President Obama announced Thursday an administrative change in one of the bedrock ideas of the new health-care law, allowing insurers to continue offering individual insurance plans for another year even if they do not comply with the law’s rules for minimum benefits.
“This fix won’t solve every problem for every person, but it’s going to help a lot of people,” Obama said in making the announcement. “Doing more will require work with Congress,” he added.
The White House, responding to intensifying pressure from disgruntled consumers and Congress, decided to make the fix as a part of a strategy to try to ward off more far-reaching changes that are being advocated on Capitol Hill. Under the White House’s approach, the Department of Health and Human Services will notify the nation’s state insurance commissioners that they have federal permission to allow consumers who already have such insurance policies to keep them through 2014. It will be up to each state whether to go along.
The decision runs counter to a central aim of the law, which was to ensure that all people in the United States with private health plans are guaranteed at least certain benefits.
Washington later became the first state to announce that it would not allow insurers to extend their policies. Saying that its state-based exchange was “up and running and successfully enrolling thousands of consumers,” Mike Kreidler, the Washington state insurance commissioner, expressed “serious concerns” about Obama’s move and “its potential impact on the overall stability of our health insurance market.”
“In the interest of keeping the consumer protections we have enacted and ensuring that we keep health insurance costs down for all consumers, we are staying the course,” he said in a statement Thursday afternoon.
Obama said the administration will insist that insurance companies continuing to sell individual health policies that do not comply with the new standards inform consumers about “what protections these renewed plans don’t include” and alert their customers to potentially better and more affordable insurance available through the new federal and state marketplaces.
The White House’s strategy differs from a bill on which the House is to vote on Friday, sponsored by Rep. Fred Upton (R-Mich.), which would let new customers buy such minimal policies, rather than allowing only existing policy-holders to keep them for an additional year.
Insurers said Thursday that while they appreciated Obama’s effort to address consumers’ concerns, they remained concerned that the move could distort the risk pool in the new state and federal health-insurance marketplaces.
“Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers,” said Karen Ignani, president and chief executive of America’s Health Insurance Plans. “Premiums have already been set for next year based on an assumption of when consumers will be transitioning to the new marketplace. If now fewer younger and healthier people choose to purchase coverage in the exchange, premiums will increase and there will be fewer choices for consumers.”
While Obama defended his administration’s efforts to fix the problems that have plagued the health-care law’s implementation, he acknowledged that the last few weeks have been rocky.
“I think it’s fair to say that the rollout has been rough so far,” Obama said, referring to the troubled debut of HealthCare.gov, the Web site for the new federal health-insurance exchange. He added that the Web site “has gotten a lot better” but work remains to be done.
“We fumbled the rollout of this health-care law,” Obama said. Regarding the policy cancellation issue, which contradicted his repeated promises that people would be able to keep insurance plans they liked, Obama said, “That’s on me. . . . That’s something I deeply regret because it’s scary getting a cancellation notice.”
Obama described both the cancellations on the individual market and the Web site rollout as significant problems, but he said the law’s implementation could still turn out well.
“These are two fumbles . . . on a big game — but the game’s not over,” he said. He vowed that the nation would not return to what he called the broken health-care system that existed before the Affordable Care Act.
“I was not informed directly that the Web site would not be working the way it was supposed to,” he said of the problems that were plaguing HealthCare.gov before its debut.
“I don’t think I’m stupid enough to go around saying, this is going to be like shopping on Amazon or Travelocity, a week before the Web site opens, if I thought that it wasn’t going to work,” he said.
Even as Obama outlined his administrative fix, he said he would continue to press ahead with the controversial health-care law.
“It is important to understand, though, that the old individual market was not working well,” he said “And it’s important that we don’t pretend that somehow that’s a place worth going back to. Too often it works fine as long as you stay healthy. It doesn’t work well when you’re sick.”
Obama said, “I will not accept proposals that are just another brazen attempt to undermine or repeal the overall law and drag us back into a broken system.”
“I’m not going to walk away from 40 million people who have the chance to get health insurance for the first time, and I’m not going to walk away from something that has helped the cost of health care grow at its slowest rate in 50 years,” he said.
When asked whether HealthCare.gov would be fully fixed by the end of the month, the president was careful not to promise that would happen by Nov. 30.
“It’s fair to say that the improvement will be marked and noticeable,” said, adding that “the Web site will work much better” than it did when it was launched on Oct. 1.
“On . . . November 30th, it will be a lot better. But there will still be some problems,” he added.
While Jeffrey Zients, the White House official in charge of fixing the online enrollment system, has said the site would work “smoothly” for “the vast majority of users” by the end of the month, Obama said that “the majority of people who go to the site” will have a good experience.
“It is not possible for me to guarantee that 100 percent of the people 100 percent of the time going on this Web site will have a perfectly seamless, smooth experience,” the president said.
“I am confident that by the time we look back on this next year, that people are going to say, this is working well, and it’s helping a lot of people,” he said.
“Buying health insurance is never going to be like buying a song on iTunes,” he said at another point in the nearly hour-long news conference. “You know, it’s just a much more complicated transaction.”
But Obama also acknowledged that the botched launch of the insurance exchanges had caused problems for his own party.
“There is no doubt our failure to roll out the [Affordable Care Act] smoothly has put a burden on Democrats, whether they’re running or not, because they stood up and supported this effort through thick and thin,” he said.
“So my commitment to them is we’re going to just keep on doing better every day until we get [the job] done,” he said.
“It is complicated. It is hard. But I make no apologies for us taking this on, because somebody, sooner or later, had to do it,” Obama said. “I do make apologies for not having executed better over the last several months.”
Under the change announced Thursday, insurance companies do not necessarily have to let consumers keep their individual plans that do not meet the new standards. Rather, states are given the option of allowing insurance companies to offer consumers the chance to keep their 2013 plans for another year.
Obama, facing a political furor over the cancellation of many Americans’ insurance plans purchased on the individual market, made the announcement at the White House before embarking on a trip to Cleveland to deliver a speech about the economy. He was then scheduled to travel to Philadelphia to attend a fundraiser for the Democratic Senatorial Campaign Committee.
The Obama administration reported Wednesday that slightly more than 106,000 Americans signed up for health plans in the first month of new state and federal insurance marketplaces. The figure, which was far lower than the administration originally predicted, points to the steep challenge ahead as the White House tries to overcome public and congressional frustration with the program’s problem-plagued rollout.
The tally showed that just a quarter of the enrollments were in the federally run marketplace, while the rest were in the state exchanges.
Speaking to reporters before Obama’s announcement, House Speaker John A. Boehner (R-Ohio) said he doubted that an administrative fix would be possible.
“When it comes to Obamacare, it’s clear that the American people simply can’t trust this White House,” he said.
“No one can identify anything the president can do administratively” that would be both legal and effective, Boehner said. He repeated the GOP’s call to “scrap this law once and for all,” adding, “There’s no way to fix this.”
Senior administration officials said that in Thursday’s announcement, Obama was trying to address some consumers’ concerns without undermining the integrity of his Affordable Care Act, widely known as Obamacare.
“This policy is in the interest of fixing some of the challenges that have arisen,” one official said, adding it would ensure “a better, smoother transition” for customers who had purchased plans on the individual market.
But allowing more Americans to opt out of the state and federal health-insurance marketplaces could divert some of the younger, healthier consumers from these plans.
The enrollment tally released Wednesday was the first official indication of the desire and ability of uninsured Americans to get coverage under the 2010 law. Slightly fewer than 27,000 enrollments occurred in the 36 states that rely on HealthCare.gov, the troubled federal Web site. The rest were in 11 of the 14 states that have created their own marketplaces, which are generally working better than the federal one. A few states are not yet reporting.
The figures, which cover Oct. 1 to Nov. 2, are significantly lower than the administration’s only known forecast, which suggested that nearly half a million people would sign up for private health plans during the first month of the initial six-month enrollment period for the exchanges. The Congressional Budget Office has predicted that 7 million people will buy coverage through the exchanges by spring.
The enrollment picture emerged as the White House tried to quell growing dissatisfaction in Congress, including among many Democrats, about complaints from people whose individual policies are being canceled because they do not comply with new coverage rules.
House Democrats from across the ideological spectrum criticized the administration’s handling of the issue at a closed-door meeting Wednesday attended by David Simas, the White House deputy senior adviser for communications and strategy, and other administration aides.
House Minority Leader Nancy Pelosi (D-Calif.) said Wednesday that the more than 200 Democrats in her caucus have grown restless and were firing off their ideas to administration officials about what to do next. “We’ve all been making suggestions. We know what the possibilities are, but I don’t know what they will choose. It’s a long list — how many members do I have?” she told reporters.
On Thursday, White House Chief of Staff Denis McDonough was scheduled to meet privately with Senate Democrats to discuss the law’s implementation.
Democratic irritation with the White House is mounting as the House prepares to vote Friday on Upton’s bill, which would permit insurers to continue to sell health plans after this year even if they do not meet new federal standards. Democratic leadership aides predicted that at least some Democrats would support the measure.
In the Senate, Democrats have offered proposals to calm consumers who are angry about canceled plans. Sen. Mark Udall (D-Colo.) introduced a bill Wednesday that would require insurers to give customers the chance to renew enrollment on certain health plans through the end of 2015. A measure sponsored by Sen. Mary Landrieu (D-La.) would require insurers to allow Americans to renew their plans indefinitely.
Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, said that all of the current bills pending in Congress, which would enable consumers on the individual market to extend their plans, could change the makeup of marketplaces’ risk pool and force insurers to raise prices.
“Premiums were set based on assumptions about people transitioning to the marketplaces,” Zirkelbach said. “Changing the rules in the middle of the game could dramatically change who actually signs up. If the exchanges become nothing more than a high-risk pool, that’s going to result in massive premium increases for consumers.”
One senior administration official said the White House still expects “a whole bunch of uninsured and young people” to opt for state and federal marketplaces even though some plans on the individual market would be extended.
The officials noted that 40 percent of the customers on the individual market are between 45 and 64 years old, meaning that the individual market is not entirely composed of young Americans. They also noted that the Kaiser Family Foundation said 17 million Americans would qualify for tax credits under the new health-care law if they opt for a plan under either the federal or state marketplaces.
Paul Kane contributed to this report.