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
Add to Briefcase
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 »
APPEALS COURT RULED TRUMP EXCEEDED HIS AUTHORITY
Supreme Court Takes Up Trump Travel Ban
7 hours ago
THE LATEST

The Supreme Court announced "that it would consider a challenge to President Trump’s latest effort to limit travel from countries said to pose a threat to the nation’s security." The case concerns Trump's most recent attempt to make good on a campaign promise "tainted by religious animus" and only questionably justified by national security concerns. The decision to take the case, called Trump v. Hawaii, comes almost exactly a year after Trump issued the first travel ban. The ban under consideration affects Iran, Libya, Syria, Yemen, Somalia, Chad and North Korea.

Source:
FACES STIFF OPPOSITION FROM BOTH PARTIES
Trump Proposes 95 Percent Cut To Office of Drug Control Budget
10 hours ago
THE LATEST

Trump wants to move the two grants, the High Intensity Drug Trafficking Areas grant and the Drug Free Communities Act, to the Justice and Health and Human Services departments, respectively. This would result in a $300 million plus reduction in funding, about 95 percent of the cost of the Office of National Drug Control Policy. "'I’m baffled at the idea of cutting the office or reducing it significantly and taking away its programs in the middle of an epidemic,'" said Regina LaBelle, who served as ONDCP chief of staff during the Obama administration. This is the second time the Trump Administration has proposed gutting the agency.

Source:
HOPES A DEAL CAN GET DONE
Schumer Meeting with Trump for Last-Ditch Meeting
11 hours ago
THE LATEST
BLURRY LINE BETWEEN BUSINESS/PRESIDENCY
New CREW Report Identifies 500 Conflicts of Interest in Trump’s First Year
11 hours ago
THE DETAILS

A new report assembled by the watchdog group Citizens for Responsibility and Ethics in Washington has identified more than 500 potential conflicts of interest in President Trump's first year. First, the report notes, Trump spent 122 days at his properties during his first year. He has been accompanied by 70 federal officials and 30 members of Congress. "Second, far from this signaled access to power being an empty promise, those who patronize President Trump’s businesses have, in fact, gained access to the president and his inner circle." Lastly, about 40 special interest groups and 11 foreign governments have held events at Trump properties.

Source:
BY SCALISE
House Told to “Stay Flexible”
12 hours ago
THE DETAILS
×
×

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