Ben Nelson Works to Build Consensus Around ACA

Middle man: Nelson believes NAIC should serve as an intermediary between state-based regulators and the Obama administration.
National Journal
Dec. 16, 2013, 4:09 p.m.

The man who cast the 60th and de­cis­ive vote for the Af­ford­able Care Act in the Sen­ate is now deal­ing with the re­per­cus­sions of the health care law’s troubled rol­lout.

Former Sen. Ben Nel­son, who has been CEO of the Na­tion­al As­so­ci­ation of In­sur­ance Com­mis­sion­ers since Janu­ary, is charged with the seem­ingly im­possible task of build­ing con­sensus among state-based reg­u­lat­ors fol­low­ing Pres­id­ent Obama’s pro­pos­al last month to delay en­force­ment of cer­tain pro­vi­sions of the Af­ford­able Care Act. The re­quest has split NA­IC’s mem­ber­ship down the middle, with half of them say­ing they will move for­ward with im­ple­ment­a­tion des­pite the White House re­quest. “It’s pretty evenly di­vided,” Nel­son said.

A former Neb­raska state in­sur­ance dir­ect­or, Nel­son is flu­ent in the finer points of the ac­tu­ar­ial pro­fes­sion. The pres­id­ent’s re­com­mend­a­tion, which would al­low con­sumers to keep non-ACA-com­pli­ant in­sur­ance policies for an­oth­er year, could raise premi­ums for the risk pool cre­ated un­der the law, he said. Fur­ther­more, many states have already passed le­gis­la­tion that re­quires the can­cel­la­tion of policies not com­pli­ant with ACA stand­ards.

Some of NA­IC’s mem­bers have pub­licly ques­tioned the or­gan­iz­a­tion’s de­cision not to re­com­mend a single course of ac­tion to its con­stitu­ents. Last month, six reg­u­lat­ors boy­cot­ted a meet­ing between Obama and NA­IC of­fi­cials.

“We made this dif­fi­cult de­cision not to at­tend due to the fact that we were either not in­vited to do so, or were in­vited but have de­clined, but in all cases we have ser­i­ous re­ser­va­tions,” wrote Adam Hamm, North Dakota’s in­sur­ance com­mis­sion­er and NA­IC’s pres­id­ent-elect, in a let­ter to fel­low mem­bers. “This meet­ing has not been dis­cussed in any mean­ing­ful way with the en­tire mem­ber­ship of the NA­IC, nor have we worked to build con­sensus among the mem­bers on what our po­s­i­tions will be in the meet­ing.”

Asked about these as­ser­tions, Nel­son is dip­lo­mat­ic but un­apo­lo­get­ic. “I don’t know that I ex­pec­ted [Hamm to boy­cott the meet­ing], but noth­ing sur­prises me,” said the ami­able 72-year-old. “The com­mis­sion­ers come from a vari­ety of dif­fer­ent back­grounds, so it’s not un­usu­al that they would end up with dif­fer­ent ideas about what they should or shouldn’t do in terms of meet­ing with the pres­id­ent”¦. The com­mis­sion­ers are [act­ing] in the best in­terests of their folks back home.”

Rather than dic­tate policy, Nel­son be­lieves that the pur­pose of the NA­IC is to serve as an in­ter­me­di­ary between state-based reg­u­lat­ors and the Obama ad­min­is­tra­tion. “The NA­IC as an or­gan­iz­a­tion takes no po­s­i­tion with re­spect to policy, but we are very di­li­gent in try­ing to as­sist the states with their loc­al im­ple­ment­a­tion,” he said. Nel­son holds at least one con­fer­ence call with his mem­ber­ship each day and has traveled to Ger­many, Switzer­land, and Taiwan in re­cent months to weigh the ef­fic­acy of in­ter­na­tion­al reg­u­lat­ory schemes.

Born in Omaha, Nel­son re­ceived a bach­el­or’s de­gree, mas­ter’s de­gree, and bach­el­or of laws from the Uni­versity of Neb­raska. A former two-term gov­ernor of Neb­raska, he was elec­ted to the Sen­ate in 2000 and promptly emerged as one of the up­per cham­ber’s most con­ser­vat­ive Demo­crats. Nel­son sup­por­ted the Bush ad­min­is­tra­tion’s tax cuts in 2001 and 2003 and broke with his party in 2007 to op­pose a plan to be­gin with­draw­ing troops from Ir­aq. In 2004, it was re­por­ted that White House strategist Karl Rove, per­haps with the in­ten­tion of con­sol­id­at­ing the Re­pub­lic­an ad­vant­age in the Sen­ate, offered to make Nel­son Ag­ri­cul­ture sec­ret­ary. Nel­son con­sidered the of­fer for five days be­fore turn­ing it down.

As law­makers draf­ted the Af­ford­able Care Act in 2009, Nel­son seemed to ex­ploit his stand­ing as the fi­nal vote needed to pass the le­gis­la­tion by adding a pro­vi­sion that brought some $100 mil­lion in bo­nus Medi­caid fund­ing to Neb­raska. The deal was ex­cised from the fi­nal ver­sion of the bill, but Nel­son was roundly cri­ti­cized for what came to be known as the “Cornhusk­er Kick­back.”

What We're Following See More »
AVOIDS SHUTDOWN WITH A FEW HOURS TO SPARE
Trump Signs Border Deal
2 days ago
THE LATEST

"President Trump signed a sweeping spending bill Friday afternoon, averting another partial government shutdown. The action came after Trump had declared a national emergency in a move designed to circumvent Congress and build additional barriers at the southern border, where he said the United States faces 'an invasion of our country.'"

Source:
REDIRECTS $8 BILLION
Trump Declares National Emergency
2 days ago
THE DETAILS

"President Donald Trump on Friday declared a state of emergency on the southern border and immediately direct $8 billion to construct or repair as many as 234 miles of a border barrier. The move — which is sure to invite vigorous legal challenges from activists and government officials — comes after Trump failed to get the $5.7 billion he was seeking from lawmakers. Instead, Trump agreed to sign a deal that included just $1.375 for border security."

Source:
COULD SOW DIVISION AMONG REPUBLICANS
House Will Condemn Emergency Declaration
2 days ago
THE DETAILS

"House Democrats are gearing up to pass a joint resolution disapproving of President Trump’s emergency declaration to build his U.S.-Mexico border wall, a move that will force Senate Republicans to vote on a contentious issue that divides their party. House Judiciary Committee Chairman Jerrold Nadler (D-N.Y.) said Thursday evening in an interview with The Washington Post that the House would take up the resolution in the coming days or weeks. The measure is expected to easily clear the Democratic-led House, and because it would be privileged, Senate Majority Leader Mitch McConnell (R-Ky.) would be forced to put the resolution to a vote that he could lose."

Source:
MILITARY CONSTRUCTION, DRUG FORFEITURE FUND
Where Will the Emergency Money Come From?
2 days ago
THE DETAILS

"ABC News has learned the president plans to announce on Friday his intention to spend about $8 billion on the border wall with a mix of spending from Congressional appropriations approved Thursday night, executive action and an emergency declaration. A senior White House official familiar with the plan told ABC News that $1.375 billion would come from the spending bill Congress passed Thursday; $600 million would come from the Treasury Department's drug forfeiture fund; $2.5 billion would come from the Pentagon's drug interdiction program; and through an emergency declaration: $3.5 billion from the Pentagon's military construction budget."

Source:
TRUMP SAYS HE WILL SIGN
House Passes Funding Deal
3 days ago
THE DETAILS

"The House passed a massive border and budget bill that would avert a shutdown and keep the government funded through the end of September. The Senate passed the measure earlier Thursday. The bill provides $1.375 billion for fences, far short of the $5.7 billion President Trump had demanded to fund steel walls. But the president says he will sign the legislation, and instead seek to fund his border wall by declaring a national emergency."

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login