Republicans, some Democrats in Congress, and even former President Clinton are putting pressure on President Obama to make good on his oft-repeated promise that, under the Affordable Care Act, people can keep their health insurance, if they like it.
House Republicans have scheduled a vote later this week on a “Keep Your Health Plan Act,” designed to allow insurance companies to keep existing coverage options in place.
This comes after Mr. Obama has been put on the defensive by reports that several million Americans are getting cancellation letters, even as a new insurance marketplace is rolling out under the Affordable Care Act (ACA). Legislation similar to the House bill has been proposed in the Senate, and is supported by some Democrats.
Even if the legislation were to pass and be signed into law, however, it’s not clear that it would resolve the challenge that many Americans now face.
The House bill, for one, doesn’t require that insurance providers reinstate cancelled policies. It merely allows them to do so. A Senate bill backed by Mary Landrieu (D) of Louisiana would impose such a requirement. But, whether the shift is voluntary or mandated, rolling back the clock isn’t easy.
“Millions of people are facing those cancellation letters,” Robert Laszewski, a health-care industry consultant, wrote in a Sunday blog post. Obamacare hasn’t changed the fact that states regulate health insurance, and “the old products are no longer filed for sale and rates are not approved [for 2014].”
Mr. Laszewski says it “might be possible to get insurance commissioners to waive their requirements.”
But then insurance companies would face a logistical morass of trying to offer the old policies, explain all the choices anew, and find out what customers want do in time for a new year of coverage to start.
The news website Politico quotes one unnamed insurance-industry official saying the House bill would be “almost impossible to operationalize … bordering on herculean.”
Meanwhile, the federal government itself has been revealing how challenging it can be to shuffle around mountains of consumer health-insurance data. The website HealthCare.gov was supposed to be ready for millions of Americans to sign up for Obamacare insurance plans starting on Oct. 1, but is still plagued by technical problems.
Obama said in a televised interview last week that his administration is looking into a “range of options” to address the policy cancellations, but he stopped short of endorsing any legislation.
At the root of the dispute is this: The Obamacare law allows people to keep health plans they had before the law was passed, if those plans still exist. But in many cases, the plans have evolved since the law’s 2010 passage – due, at least in part, to minimum benefits mandated in the new law. That has prompted many Americans to feel misled by the president.
Many people who like their 2013 plans are finding they can’t keep them for 2014.
“I have had scores of constituents calling my office telling me they want him to keep his promise,” Rep. Charlie Dent (R) of Pennsylvania said this week, in a statement announcing his support for the House legislation.
The bill, introduced by Rep. Fred Upton (R) of Michigan, who chairs the House Energy and Commerce Committee, would allow insurers serving the individual market to keep offering 2013 plans, without needing to comply with Affordable Care Act rules defining minimum benefits.
In many cases, the coverage deemed “minimum” under Obamacare is more expensive than the plans people might leave behind.
Obama and many Democrats say the price may be higher, but families will get a better deal, because they’ll have much stronger coverage should they become sick or injured.
Many Republicans argue that Obamacare represents a one-size-fits-all approach to insurance that won’t help to control costs or serve consumers well.
The tussle over how to respond to the policy cancellations is just part of a broader political battle over the law. With congressional elections just a year away, and signups for Obamacare insurance off to a rocky start on the new federal website, Democrats are feeling pressure to show the law can work – that is, help millions of uninsured Americans get coverage without harming those who are already insured.
Some Senate Democrats, including Mark Pryor of Arkansas as well as Senator Landrieu, have voiced support for legislation similar to the Republican House bill. Both are up for reelection in 2014.
Obama, meanwhile, has acknowledged his setback.
Last week, he reformulated his “you can keep it” pledge to make it more accurate. “If you have or had one of these plans before the Affordable Care Act came into law and you really like that plan, what we said was you could keep it, if it hasn’t changed since the law was passed,” he said.
Because most plans have evolved since 2010 passage, the “if” in Obama’s statement is a big one.
On Thursday, in an interview on NBC News, he offered an apology to Americans who lost plans that they liked: "I am sorry that they are finding themselves in this situation, based on assurances they got from me.”
House Speaker John Boehner (R) of Ohio used that White House apology as an occasion to push for a legislative remedy.
“If the president is sincerely sorry that he misled the American people, the very least he can do is support this bipartisan effort,” he said.
In a blow to the administration, Mr. Clinton has added his voice to the chorus, saying in a Tuesday interview at OZY.com that Obama should find a way to honor his pledge “even if it takes a change in the law.”
White House spokesman Jay Carney said Tuesday that the House bill could throw "the baby out with the bath water" by allowing people to keep signing up for plans that don't meet Obamacare standards.
Supporters of the law want Americans to have stronger health benefits, not grandfathered ones that Obama has labeled "substandard."
A related concern for the White House is whether Obamacare's math will work. The law envisions insurers getting enough revenue – partly from people who now face higher premiums after getting cancellation letters – to meet their costs of expanding coverage under the law. If that doesn't happen, premiums could jump next year as insurers set rates for 2015.