Obamacare Fix Shifts Responsibility to Insurers

A CMS letter to insurance commissioners leaves the decision to continue coverage plans up to issuers.

WASHINGTON, DC - NOVEMBER 14: U.S. President Barack Obama speaks about an administrative fix for some of the problems with the HealthCare.gov. website in the Brady Press Briefing Room at the White House on November 14, 2013 in Washington, DC. The president announced that canceled insurance plans would be renewed for a year. (Photo by Win McNamee/Getty Images)
National Journal
Sophie Novack
Nov. 14, 2013, 9:54 a.m.

A let­ter sent to in­sur­ance com­mis­sion­ers Thursday out­lines White House guid­ance to ad­dress the prob­lem of in­sur­ance can­cel­la­tions un­der Obama­care. The let­ter places the onus on in­surers to choose wheth­er they will con­tin­ue of­fer­ing can­celed or would-be can­celed plans.

“Health in­sur­ance is­suers may choose to con­tin­ue cov­er­age that would oth­er­wise be ter­min­ated or can­celed, and af­fected in­di­vidu­als and small busi­nesses may choose to re-en­roll in such cov­er­age,” says the let­ter, sent from Gary Co­hen, dir­ect­or of con­sumer in­form­a­tion and in­sur­ance over­sight at the Cen­ters for Medi­care and Medi­caid Ser­vices.

The ad­min­is­trat­ive fix al­lows in­sur­ance com­pan­ies to con­tin­ue of­fer­ing plans that do not meet the new, more-com­pre­hens­ive stand­ards set un­der the health care law.

Un­der what is re­ferred to as a “trans­ition­al policy,” in­surers and con­sumers will be al­lowed to re­new their cov­er­age in the in­di­vidu­al or group mar­ket for the policy year between Jan. 1, 2014 and Oct. 1, 2014. 

The guid­ance comes with cer­tain con­di­tions. Cov­er­age must have been in ef­fect on Oct. 1, 2013, so new cus­tom­ers can­not pur­chase these plans, and the in­sur­ance com­pan­ies must in­form con­sumers of al­tern­at­ive op­tions avail­able through the health in­sur­ance mar­ket­place.

“State agen­cies re­spons­ible for en­for­cing the spe­cified mar­ket re­forms are en­cour­aged to ad­opt the same trans­ition­al policy with re­spect to this cov­er­age,” the let­ter reads. 

The policy does not, however, re­quire com­pan­ies to com­ply, and in­dustry ex­perts say it may be too late to re­verse can­cel­la­tions.

Obama was not shy about the polit­ic­al nature of the an­nounce­ment Thursday.

“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. “Now, what folks may find is, the in­sur­ance com­pan­ies may still come back and say, ‘We want to charge you 20 per­cent more than we did last year, or we’re not go­ing to cov­er pre­scrip­tion drugs now.’ “

Need­less to say, in­sur­ance com­pan­ies aren’t so pleased with the solu­tion.

What We're Following See More »
‘PRESUMPTIVE NOMINEE’
Priebus Asks Party to Unite Behind Trump
5 hours ago
THE LATEST
FEELING THE MIDWESTERN BERN
Sanders Upsets Clinton in Indiana
6 hours ago
THE LATEST

Despite trailing Hillary Clinton by a significant margin, Bernie Sanders wasn't going the way of Ted Cruz tonight. The Vermont senator upset Clinton in Indiana, with MSNBC calling the race at 9pm. Sanders appears poised to win by a five- or six-point spread.

Source:
TRUMP IS PRESUMPTIVE NOMINEE
Ted Cruz Bows Out, Effectively Ceding the Contest to Trump
7 hours ago
THE LATEST

And just like that, it's over. Ted Cruz will suspend his presidential campaign after losing badly to Donald Trump in Indiana tonight. "While Cruz had always hedged when asked whether he would quit if he lost Indiana; his campaign had laid a huge bet on the state." John Kasich's campaign has pledged to carry on. “From the beginning, I’ve said that I would continue on as long as there was a viable path to victory,” said Cruz. “Tonight, I’m sorry to say it appears that path has been foreclosed."

Source:
TAKES AT LEAST 45 DELEGATES
Trump Wins Indiana, All but Seals the Nomination
7 hours ago
THE LATEST

The Republican establishment's last remaining hope—a contested convention this summer—may have just ended in Indiana, as Donald Trump won a decisive victory over Ted Cruz. Nothing Cruz seemed to have in his corner seemed to help—not a presumptive VP pick in Carly Fiorina, not a midwestern state where he's done well in the past, and not the state's legions of conservatives. Though Trump "won't secure the 1,237 delegates he needs to formally claim the nomination until June, his Indiana triumph makes it almost impossible to stop him. Following his decisive wins in New York and other East Coast states, the Indiana victory could put Trump within 200 delegates of the magic number he needs to clinch the nomination." Cruz, meanwhile, "now faces the agonizing choice of whether to remain in the race, with his attempt to force the party into a contested convention in tatters, or to bow out and cede the party nomination to his political nemesis." The Associated Press, which called the race at 7pm, predicts Trump will win at least 45 delegates.

Source:
THE QUESTION
What’s the Average Household Income of a Trump Voter?
12 hours ago
THE ANSWER

Seventy-two thousand dollars, according to FiveThirtyEight. That's higher than the national average, as well as the average Clinton or Sanders voter, but lower than the average Kasich voter.

Source:
×