Can Obama Fix Health Care Cancellations?

The president says he’s looking for a solution, but experts don’t see many options.

President Barack Obama speaks at Temple Emanu-El November 6, 2013 in Dallas, Texas.
National Journal
Sam Baker
Nov. 11, 2013, 7:12 a.m.

Pres­id­ent Obama says he’s look­ing for a “fix” to ad­dress can­celled in­sur­ance plans. That doesn’t mean he’ll find one.

Obama has dir­ec­ted his health care ad­visers to look for a way to deal with the wave of can­cel­la­tion no­tices hit­ting some poli­cy­hold­ers. But health policy ex­perts have no idea what the White House could ac­tu­ally do to al­le­vi­ate the stick­er shock some con­sumers are fa­cing.

“I can’t ima­gine what they’re think­ing about,” said Tim Jost, a Wash­ing­ton & Lee Uni­versity law pro­fess­or and an ex­pert on the Af­ford­able Care Act.

Policy wonks on both sides of the health care de­bate held open the pos­sib­il­ity that the ad­min­is­tra­tion will come up with something — there have been too many sur­prises already in the im­ple­ment­a­tion pro­cess to rule any­thing out. But it’s hard to see what the White House could do, on its own and spe­cific­ally without Con­gress, that would make much of a dif­fer­ence.

That’s partly be­cause these plan can­cel­la­tions are not a side ef­fect of the Af­ford­able Care Act. The ad­min­is­tra­tion knew they were com­ing, and they were an in­ev­it­able part of the re­forms the law makes to the mar­ket for in­di­vidu­al in­sur­ance policies.

Weak­en­ing the reg­u­la­tions that led to plan can­cel­la­tions might not make any dif­fer­ence at all, or might un­der­mine the ba­sic struc­ture of the law. And try­ing to simply of­fer more as­sist­ance to people los­ing their plans would re­quire con­gres­sion­al ap­prov­al — which, of course, Obama wouldn’t get.

An ad­min­is­tra­tion of­fi­cial con­firmed that the White House is look­ing for ad­min­is­trat­ive fixes, not le­gis­lat­ive ones. That would ap­pear to rule out high­er sub­sidies to help people pay for cov­er­age, an idea floated to The Huff­ing­ton Post after Obama’s in­ter­view.

Obama him­self ac­know­ledged in last week’s NBC News in­ter­view that he doesn’t think the can­cel­la­tions them­selves are a prob­lem. He apo­lo­gized for the con­fu­sion and dis­rup­tion the no­tices have caused, but main­tained that most people would get a bet­ter deal by pur­chas­ing cov­er­age through the health care law’s new mar­ket­places.

“We really be­lieve that ul­ti­mately they’re go­ing to be bet­ter off,” Obama said.

The people hurt most by plan can­cel­la­tions are healthy con­sumers who were able to get cheap policies with de­cent cov­er­age, and who are too wealthy to qual­i­fy for Obama­care’s in­sur­ance sub­sidies. They are “losers” now be­cause they were “win­ners” un­der the old sys­tem, in which in­surers set premi­ums for each in­di­vidu­al plan based on the health of the in­di­vidu­al buy­ing it.

That sys­tem put people with preex­ist­ing con­di­tions at a huge dis­ad­vant­age — and that’s the im­bal­ance the Af­ford­able Care Act tries to cor­rect by mov­ing healthy people in­to the same risk pool as sick people.

So, leav­ing those healthy cus­tom­ers on their old plans just to solve a polit­ic­al head­ache might only help prop up the two-tiered sys­tem Obama­care was de­signed to end.

Even if the ad­min­is­tra­tion could find a middle ground, weak­en­ing or delay­ing cer­tain reg­u­la­tions might not make much dif­fer­ence.

In­sur­ance com­pan­ies have already set their premi­ums for 2014, so the high­er prices some con­sumers are ex­per­i­en­cing aren’t go­ing to change this year. And in­surers’ busi­ness mod­els already ac­count for mov­ing people in­to the health care law’s new in­sur­ance mar­ket­places.

“In short, I’m flum­moxed,” Uni­versity of Michigan law pro­fess­or Nich­olas Bagley wrote at the In­cid­ent­al Eco­nom­ist blog. “Maybe the ad­min­is­tra­tion has something cre­at­ive up its sleeve, and it’s cer­tainly prudent to re­serve any kind of fi­nal judg­ment un­til we learn more. For now, though, col­or me skep­tic­al.”

What We're Following See More »
A DARK CLOUD OVER TRUMP?
Snowstorm Could Impact Primary Turnout
2 days ago
THE LATEST

A snowstorm is supposed to hit New Hampshire today and “linger into Primary Tuesday.” GOP consultant Ron Kaufman said lower turnout should help candidates who have spent a lot of time in the state tending to retail politicking. Donald Trump “has acknowledged that he needs to step up his ground-game, and a heavy snowfall could depress his figures relative to more organized candidates.”

Source:
IN CASE OF EMERGENCY
A Shake-Up in the Offing in the Clinton Camp?
2 days ago
THE DETAILS

Anticipating a primary loss in New Hampshire on Tuesday, Hillary and Bill Clinton “are considering staffing and strategy changes” to their campaign. Sources tell Politico that the Clintons are likely to layer over top officials with experienced talent, rather than fire their staff en masse.

Source:
THE LAST ROUND OF NEW HAMPSHIRE POLLS
Trump Is Still Ahead, but Who’s in Second?
1 days ago
THE LATEST

We may not be talking about New Hampshire primary polls for another three-and-a-half years, so here goes:

  • American Research Group’s tracking poll has Donald Trump in the lead with 30% support, followed by Marco Rubio and John Kasich tying for second place at 16%. On the Democratic side, Bernie Sanders leads Hillary Clinton 53%-41%.
  • The 7 News/UMass Lowell tracking poll has Trump way out front with 34%, followed by Rubio and Ted Cruz with 13% apiece. Among the Democrats, Sanders is in front 56%-40%.
  • A Gravis poll puts Trump ahead with 28%, followed by Kasich with 17% and Rubio with 15%.
IT’S ALL ABOUT SECOND PLACE
CNN Calls the Primary for Sanders and Trump
1 days ago
THE LATEST

Well that didn’t take long. CNN has already declared Bernie Sanders and Donald Trump the winners of the New Hampshire primary, leaving the rest of the candidates to fight for the scraps. Five minutes later, the Associated Press echoed CNN’s call.

Source:
×