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Obama in Bind Trying to Keep Health Law Vow

November 13, 2013
The New York Times
Michael Shear and Robert Pear

Under intense bipartisan pressure to answer mounting consumer complaints about the botched health care rollout, White House officials are struggling to make good on President Obama’s promise that Americans can keep their insurance coverage without undermining the new health law or adding unaffordable costs.

After the president’s apology last week for wrongly assuring Americans that they could retain their health plans if they wanted, senior White House aides said the president wanted to ensure that people who were forced off older policies with less comprehensive coverage were not stuck with higher monthly premiums to replace their insurance. But administration officials declined to say how they might achieve that goal, how much it would cost or whether it would require congressional approval.

At the same time, officials signaled the president’s strong opposition to calls from across the political spectrum — including one Tuesday from a key ally, former President Bill Clinton — to support bipartisan legislation that would allow people to keep their current insurance plans even after provisions of the Affordable Care Act go into effect next year.

White House officials refused to discuss in detail what options Mr. Obama was considering. But they made clear that the president was skeptical of any solution that would allow insurance companies to continue selling what officials consider to be cheap and substandard policies.

“Broadly speaking, we do not see that as fixing the problem,” Jay Carney, the White House press secretary, said Tuesday.

The split between lawmakers and the White House reflects the dilemma the president finds himself in as he seeks to follow through on last week’s acknowledgment about his incorrect promise on health care coverage. Hundreds of thousands of people have received cancellation notices from health insurance companies because their plans do not conform with minimum standards set by the new law.

With lawmakers promoting their simple-sounding solution, the challenge for Mr. Obama is to find a workable and politically practical way to address the issue to the satisfaction of those who have lost policies.

“Any fix that would essentially open up for insurers to sell new plans that did not meet the standards would create more problems than it would fix,” Mr. Carney told reporters. It was unclear how the administration could make new plans more affordable, or whether that solution would be interpreted by Americans as keeping the promise that the president made in selling the health care law. Republicans in Congress would be certain to oppose efforts by the White House to expand subsidies.

The idea of passing legislation to allow all Americans to keep their coverage got a fresh boost on Tuesday when Mr. Clinton added his voice to the debate. In an interview, Mr. Clinton joined the intensifying criticism of the health care rollout and called on Mr. Obama to accept a change in the health care law that would allow insurance companies to keep selling policies that do not meet the new standards.

“I personally believe even if it takes a change in the law, the president should honor the commitment the federal government made to those people and let them keep what they got,” Mr. Clinton said in the interview, published by Ozy, a web magazine.

Mr. Clinton, who tried to pass a health care overhaul during his presidency, has been a powerful advocate for the Affordable Care Act, especially among the president’s key Democratic constituencies. And Mr. Clinton’s wife, Hillary Rodham Clinton, is weighing a White House bid in 2016 that could be affected by the fortunes of the health care law.

Mr. Clinton followed a steady stream of Democrats who have announced their support for legislation to let people keep their coverage. Senator Dianne Feinstein, Democrat of California, endorsed one such effort by Senators Mary L. Landrieu of Louisiana and Joe Manchin III of West Virginia, both Democrats.

“Since the beginning of September, I have received 30,842 calls, emails and letters from Californians, many of whom are very distressed by cancellations of their insurance policies and who are facing increased out-of-pocket costs,” Ms. Feinstein said. “The Landrieu bill is a common-sense fix that will protect individuals in the private insurance market from being forced to change their insurance plans.”

Ms. Landrieu, who faces a difficult election fight next year, said the cancellation notices “should have never gone out.”

“We said, and the president said over and over, that if people have insurance and they like the insurance they have, they can keep it,” Ms. Landrieu said. “That is my bill. That is the single focus of my bill. It is not to undermine the Affordable Care Act. It is to strengthen it and to keep our promise to millions of Americans.”

The White House declined to comment specifically on Ms. Landrieu’s bill, but said that another effort by Representative Fred Upton, Republican of Michigan,and the chairman of the House Energy and Commerce Committee, was especially problematic. Under Mr. Upton’s bill, an insurer that had individual policies in effect on Jan. 1 of this year could continue to “offer such coverage for sale during 2014” in the market outside an exchange.

Representative Henry A. Waxman of California, the senior Democrat on the Energy and Commerce Committee, denounced the bill as an effort to undermine the health care law.

“The bill would continue to allow insurers to exclude people from coverage based on pre-existing conditions,” Mr. Waxman said. “It would allow insurers to charge women twice as much as men for the same coverage.”

The concerns from Mr. Waxman and the White House echo those of insurance company executives themselves, who say the legislation under consideration would create huge operational challenges. Insurance is generally regulated by the states, they say, and the old policies have not been approved for sale beyond next month.

With just over a month before the deadline for consumers to enroll for coverage that begins Jan. 1, it is still not clear how many people have managed to sign up for coverage. Projections based on a Nov. 3 report attributed to the Blue Cross and Blue Shield Association suggest that at most 40,000 people had enrolled for insurance through the online federal exchange by Nov. 3.

The association decided to stop issuing its weekly enrollment report after The Wall Street Journal published an article on the numbers, according to two people familiar with the decision. In a statement, Alissa Fox, a vice president at the association, said she had not seen the enrollment report and could not verify that it was authentic.

Insurers say that allowing people to keep their existing policies would upend the assumptions built into new policies and rates for next year and lead to higher premiums for consumers.

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