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November 15, 2013

House GOP gets its say on insurance cancellations

WASHINGTON —  Republicans renewed an assault on President Barack Obama's health care overhaul and his own credibility on Friday as they pushed toward House passage of a measure to let insurers keep offering health coverage that falls short of the law's standards.

A day earlier, the president changed course in the face of a public uproar and said he would take administrative action — which doesn't need congressional approval — to let companies continue selling such plans for at least another year. Unlike the House GOP bill, he would permit such sales to insurers' existing customers only, not to new ones.

Obama's proposal drew derision from House Republicans, who have staged more than 40 votes aimed at repealing all or part of the 2010 law.

"Can we really trust the administration that wrote this disastrous missive in the first place and so mishandled the implementation, do we trust them now to fix it?" Rep. Michael Burgess, R-Texas, said Friday.

Burgess, a doctor, said that while the GOP measure wouldn't fix the law, "It is merely to stop the bleeding. It's an effort at triage."

Democrats said Republicans' only goal was to sabotage the entire law.

"I know you don't like the president," said Rep. James McGovern, D-Mass. "But get over it and do what's right for the American people."

McGovern said the GOP wanted to "undo all the protections that allow you to keep your kids on your insurance policy till they're 26" and forbid insurers from barring customers with pre-existing medical conditions.

An AP survey shows insurers have mailed at least 4.2 million cancellation notices to customers. But insurance companies and state commissioners are warning that premiums will rise if changes are made this close to the new year and insurers can keep selling substandard policies.

The impact of Obama's proposal was to shift responsibility for cancellations from the administration to state insurance regulators and the industry itself.

"What we want to do is to be able to say to these folks, you know what, the Affordable Care Act is not going to be the reason why insurers have to cancel your plan," Obama said Thursday of the millions who have received cancellation notices.

The president's shift also was designed to redeem his long-ago pledge that people who liked their coverage could keep it.

Republicans said they intended to push ahead with their plan to allow companies to continue to sell the plans to new customers as well as existing ones, and challenged Obama to work with them.

"If the president were sincere in his apology and serious about keeping his promise to the American people, he would work with Congress on bipartisan proposals," said Rep. Fred Upton, R-Mich., the main supporter of the GOP measure.

While passage was expected in the GOP-controlled chamber, a combination of the president's announcement and a Democratic alternative measure seemed likely to make the vote a clearly partisan one. The White House said late Thursday the president would veto the GOP legislation.

The Democratic version, which faced certain House rejection, would let insurers continue coverage deemed substandard under the law for many existing customers, but only through 2014. It would also require insurance companies to tell people they could purchase other policies on federal or state-run insurance exchanges that might be better and cost less.

Meanwhile, Obama was set to meet Friday with health insurance CEOs to discuss helping people enroll in new plans and ways to minimize disruptions as people switch to new plans, a White House official said. The official asked to speak anonymously because the person was not authorized to talk publicly about the meeting ahead of the session.

The maneuvering on many fronts came on an issue that has been a constant cause of controversy since Obama called for sweeping health care legislation in his first inaugural address nearly five years ago on the steps outside the Capitol.

His remarks on Wednesday marked a reversal with his personal and political credibility on the line, even though the impact on consumers is unclear.

Obama's approval ratings in polls are also ebbing, and he readily conceded that after recent events the public can legitimately "expect me to have to win back some credibility on this health care law in particular and on a whole range of these issues in general."

Shortly after Obama spoke, the major industry trade group, America's Health Insurance Plans, warned in a statement that prices might rise as a result of his new policy. "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," it said.

A few hours later, the head of the National Association of Insurance Commissioners added a fresh word of caution. Louisiana Insurance Commissioner Jim Donelon, president of the group, said Obama's proposal could lead to higher premiums and market disruptions next year and beyond.

Until the president made his announcement, the administration had been assuming that individuals currently covered by plans marked for cancellation would switch to alternatives offered in government-established exchanges. If so, they would be joining millions of others who have lacked insurance in the past.

The people with current individual coverage are a known risk to insurers. But those without generally have had less access to medical services and are most costly to care for. The theory has been that moving people with current coverage into the new markets would help stabilize premiums.

Only last week, Health and Human Services Secretary Kathleen Sebelius told a Senate panel she doubted that retroactively permitting insurers to sell canceled policies after all "can work very well since companies are now in the market with an array of new plans. Many have actually added consumer protections in the last 3 1/2 years."

 

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