Darryl Paulson: The Obamacare mess keeps getting messier

At his Nov. 14 news conference, President Obama proposed a “temporary fix” to the Affordable Care Act (ACA) in an attempt to stop the growing public criticism of the president and to stop Democrats from jumping ship.

“We fumbled the rollout on the health care law. . . If I fumble the ball, you know, I’m going to wait until I get the next play and then I’m going to try to run as hard as I can and do right by the team,” said Obama.

The proposed fix, by administrative action, allows insurance companies to offer their plans for another year, but only to those already enrolled in such plans.  The administration is asking the insurance companies to do this, but they cannot compel them to do so.

Insurance companies that decide to comply with the White House request must do two things.  First, they must tell their customers of the various health benefits missing from the plan that are required in ACA plans.  Second, they must inform clients that other options are available on the exchanges.  How many insurance companies comply with these guidelines remains to be seen.

The insurance industry is livid with the president.  He has spent much of the past few years attacking insurance companies for their substandard policies and blaming them for canceling policies.  Now, the president wants them to “take a bullet” for the president.

Insurance companies have been working with the White House for several years trying to get the ACA up and running.  They have taken heat from customers who have seen their policies cancelled.  They are hardly in the mood to cooperate with the president.

Robert Laszewski, an insurance industry consultant, responded to Obama’s demands and the new burdens they would place on the industry.  He observed that insurance companies would “have 32 days to reprogram their computer systems for policies, rates, and eligibility, send notices to the policyholders via U.S. mail, send a very complex letter that describes just what the differences are between specific policies and Obamacare compliant plans, ask the consumer for their decision — and give them a reasonable time to make that decision — and then enter those decisions back into their systems without creating massive billing, claim payment, and provider eligibility list mistakes.”

Both Republicans and Democrats in Congress have offered their own alternatives to fix the ACA.  One plan is Congressman Fred Upton’s “Keep Your Health Plan Act of 2013.”

His plan allows insurers to continue offering their current plans, as well as new plans that are not ACA compliant.  The plan allows anyone to purchase those plans and not just those currently enrolled.

Sen. Mary Landrieu, D-La., has offered the “Keeping the Affordable Care Act’s Promise Act.”  It requires insurance companies to continue offering the plans they have already or will cancel.  Insurance companies would not have a choice to offer or cancel such plans.

Critics of the Landrieu plan point out that healthier and younger people would stay in these plans, thereby pushing up premium costs in the ACA exchanges.

A second Democratic proposal comes from Sen. Mark Udall.  His “Continuous Coverage Act” is similar to the Landrieu bill, but it would run for only two years.  Once the ACA is up and running, the non-compliant plans would end.

The House voted 261 to 157 on Friday to pass the Upton plan.  Thirty-nine Democrats defected from the President and supported the Republican plan.  None of the proposals is likely to reach the President’s desk, but they do provide political cover for Democrats facing increasing opposition from the public to Obamacare.

The President offered his fix not only to stem defections by Democrats, but also to halt the damage to his reputation.  In addition, the president and many Democrats are concerned with the potential political problems associated with the bungled rollout.

A review by McClatchy Newspapers estimates that as many as 52 million Americans could lose their current insurance plans.  As the 2014 election approaches, these people will have been hit with sticker shock and lost coverage and the doctors they were told they could keep.  An unhappy electorate will be looking to punish the party that created the mess.

Debbie Wasserman Schultz, D-Fla., head of the Democratic National Committee, told Candy Crowley of CNN that Democrats should “run on Obamacare as an advantage leading into the 2014 election.”  These Democrats may need Obamacare to try to heal the political wounds they are likely to suffer.

Obama’s approval rating on handling health care is falling fast.  The President’s overall approval rating has dropped six points in the past month to a new low of 39 percent.

Obama’s short-term fix on Obamacare will create long-term problems for him and fellow Democrats.  He may find fellow Democrats doing something that no one thought was possible, agreeing with Republican Speaker John Boehner.

“The only way to fully protect the American people is to scrape the law once and for all,” said Boehner.  “There’s no way to fix this.”

Darryl Paulson

Darryl Paulson is Emeritus Professor of Government at USF St. Petersburg.


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