Saturday, October 25, 2014

News
After the big Obamacare apology: where things stand
by Chris Patterson


(CNN) -- President Barack Obama's apology to Americans whose health insurance is being canceled over the Affordable Care Act raises questions about how to fix that problem -- even as his administration scrambles to overcome a shaky website slowing down those who want to sign up for coverage.

 
Obama's now promised to address both issues fully, already putting a website fix in motion with the goal of offering a much smoother shopping and buying experience for consumers by month's end.
 
There is no strategy yet for responding to cancellations, but aides are instructed to seek remedies that can be carried out without reopening Obamacare legislation in Congress where conservative Republicans are energized by the program's flaws and hope to get rid of the law for good.
 
Health Secretary Kathleen Sebelius said on Friday in Atlanta that no specifics have emerged for addressing cancellations. The White House said solutions must also include educating consumers who have lost their plans about available options that might allow them to afford new ones.
 
The cancellation problem
 
Insurers are sending cancellation notices to some of the 12 million Americans whose individual policies don't meet Obamacare requirements for more comprehensive care.
 
Obama got into trouble for repeatedly saying over the years that Americans could keep their plans if they liked them under Obamacare. That proved untrue in a number of cases, prompting a political uproar in Washington and further unnerving Democrats already rattled by the website failure.
 
In an exclusive interview with NBC News on Thursday, Obama acknowledged the difficulty facing those whose policies purchased individually were being canceled due to Obamacare.
 
"It's scary to them. And I am sorry that they, you know, are finding themselves in this situation, based on assurances they got from me," he said.
 
He also acknowledged that "we didn't do a good enough job in terms of how we crafted the law," which is something that "I regret."
 
The law does "grandfather" plans purchased before it was enacted in 2010. But those whose policies have changed since then must get new coverage that meets new mandates.
 
Under Obamacare, insurers cannot discriminate for preexisting conditions and must cover mental health, maternity care, and other areas. Some companies appear to be canceling policies for other reasons, such as withdrawing from states where they have fewer subscribers to save money.
 
The solution
 
White House spokesman Josh Earnest told reporters "the President is determined to address some of the challenges from this law."
 
More details on the administration's thought process began to emerge even though no specific solutions have been offered.
 
First off, Sebelius said some people "have sort of been locked into coverage" with preexisting conditions and were delighted to have their plans, which are no longer available. She also said some who have received cancellation notices are "not at all unhappy" to now have choices.
 
Senior administration officials told CNN the president is seeking administrative solutions.
 
Some experts have suggested one approach could be to ask insurers to delay the cancellation of plans and extend them into 2014 so that people are not left without insurance. That has been done in California.
 
Earnest also said "many people" receiving cancellation letters -- about 1 million -- "are people who otherwise would qualify" for Medicaid, the federal insurance program for the poor.
 
He also said others might qualify for tax credits to help them offset the cost of coverage, and others still might find that they can buy "health care plans that are as good as the plan that they currently have" in the Obamacare exchange marketplaces for the same price or less.
 
"So one of the other challenges that we face is educating people about this system," Earnest said.
 
Congress wants its say
 
House Speaker John Boehner welcomed Obama's apology but said he should back a legislative fix if he's really serious. The House will vote next week to allow anyone with an individual health care plan they like to keep it.
 
Some have suggested Obama agree to extend the March 31 Obamacare signup deadline.
 
Others like Sens. Joe Manchin, a West Virginia Democrat, and Mark Kirk, an Illinois Republican, have introduced legislation to delay by a year the tax penalty for people who choose to go without insurance and are not covered by Medicaid or other government insurance program.
 
The Manchin-Kirk bill would prevent any penalty before January 1, 2015.
 
The sign-up issue does not impact most Americans with health insurance because they have coverage through an employer.
 
During a conference call with House Democratic leaders on Friday, some members back home this past week said they got a lot of questions about cancellations from constituents, according to one aide. There was no discussion about potential fixes.
 
Online woes, effort to fix
 
The October 1 rollout of the federal HealthCare.gov where consumers could shop around and enroll in Obamacare plans on privately run health exchanges was a debacle.
 
Fundamental technical issues prevented people -- including Obama at one point -- from even signing onto the HealthCare.gov site.
 
In the NBC interview, Obama reiterated that he's "confident" a "majority of people" will be able to use the website and apply for insurance by November 30.
 
In an update, CMS said on Friday it is still prone to errors and slow response times, but it has improved since its disastrous launch.
 
A key part of the site will be down over the Veterans Day weekend, including Monday, Centers for Medicare and Medicaid Services spokeswoman Julie Bataille told reporters on a conference call.
 
Jeffrey Zients, the management consultant and once and future White House staffer brought in to oversee fixes, said the system was slow and sporadic for many users this week.
 
"As we put new fixes in, volume is increasing, exposing new storage, capacity and software issues," Zients said.
 
The weekend outage, according to Zients, will allow administrators to work through a dozen or more of the issues on their punch list.