Government to Pick Plans for Displaced Health Law Customers; Bill Clinton Weighs In on Obamacare Shortcomings

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The insurance markets were envisioned as dynamic engines of private competition. But in many states, they have run into problems. Worried that insurers bailing out of the health law’s markets may prompt their customers to drop out, too, the Obama administration plans to steer affected policyholders to remaining insurance companies, according to Kaiser Health News.

Consumers may get a jolt if their new #Obamacare health plan isn’t what they’re use to Click To Tweet

But those consumers could get an unwelcome surprise if their new government-recommended plan isn’t what they’re accustomed to. The backstop was outlined in an administration document circulating among insurers and state regulators. It also calls for reaching those “discontinued consumers” with a constant stream of reminders as the health law’s 2017 sign-up season goes into high gear. Open enrollment for HealthCare.gov starts Nov. 1 and ends Jan. 31. A copy of the strategy was provided to the Associated Press.

Some consumer advocates say this latest effort will help people retain coverage in a challenging year when premiums also are rising. Other advocates, however, worry it will cause confusion. Insurers fear a backlash from customers disappointed with reduced options. The administration says consumers have the last word on accepting any “alternate” plan they’re offered.

“I’m concerned that the alternative plan will look like a ‘recommended choice’ by the marketplace,” said Elizabeth Colvin, director of Insure Central Texas, an Austin nonprofit that helps people sign up for coverage. “The way it is presented could be interpreted as, ‘This is a plan we recommend,’ or ‘This is a plan we think will work for you,’ or ‘this is one of the better plans,’” Colvin said.

The administration said it isn’t able to provide an estimate of the number of people who’ll get notices about their new plans. It could range from several hundred thousand to 1 million or more, say independent experts.

Big-name insurers are leaving the market because of financial losses and nonprofit insurance co-ops are collapsing. Insurers say customers have turned out to be sicker than expected. Many younger, healthier people have stayed away, even at the risk of fines for being uninsured.

Markets such as HealthCare.gov provide subsidized private coverage for people who don’t have a job-based plan. About 11 million people are currently covered. The original idea was that competitive markets would force insurers to offer quality coverage at affordable prices. That tends to work in metro areas. But many rural communities and small cities will have just one carrier next year.

“If you want as many people as possible to remain covered, what they are doing is a good idea,” said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for low-income people. “They are doing the best they can with a difficult situation on this one.” (Source: The Associated Press)

Steve’s Take: The long-standing good, oh heck, grand, vibes between President Barack Obama and former commander-in-chief Bill Clinton got wacked out a bit last week.

First came news that insurers are fleeing Obamacare to such an extent that the government is stepping in to shepherd individual customers who have, or will, drop out of his namesake’s health program to whatever remaining private insurers are available. No one is arguing that such a situation is a positive development.

Then in a baffling choice of language, former President Bill Clinton made some off-the-cuff, off-key remarks about problems with the Affordable Care Act that immediately reverberated through House and Senate races, undermining his party’s campaign message that the law is functioning as envisioned and potentially complicating efforts to shore it up.

Republican candidates across the country have been pointing to Mr. Clinton’s comments that the law’s impact on people who had insurance before its enactment was “the craziest thing in the world,” according to The Wall Street Journal.

Later, Mr. Clinton clarified; well, he chose different words. This time he said he believed the law was correct to have changed the way insurance was priced and sold such that people with so-called “pre-existing conditions” could also purchase it. But it is his original comments (i.e., “the craziest thing” metaphor, etc.) that of course were rapidly circulating.

“This clip will appear in every House Republican members’ ad, over and over, all across the country,” predicted Robert Blendon, a health policy professor at Harvard University. “It’s made this issue more significant in the election. The Democrats will be forced to respond.”

In appearing to challenge the law’s basic ability to reform insurance markets, Mr. Clinton put himself at odds with not only his wife but also President Barack Obama, and lawmakers in Congress who hope to make the repairs that will preserve the law.

Hillary Clinton, the Democratic candidate for president, has said the law needs relatively small changes rather than a drastic reversal in course. That is also the message of Democrats in House and Senate races across the country. Instead, they are hearing Republicans play back Mr. Clinton’s suggestion that the law is more deeply flawed, and that only a government-run health plan could ultimately work for many Americans.

“You’ve got this crazy system where all of a sudden, 25 million more people have health care and then the people that are out there busting it–sometimes 60 hours a week–wind up with their premiums doubled and their coverage cut in half,” Mr. Clinton had said last Monday in Flint, MI.

The remarks captured the disruption experienced by healthy people who had enjoyed low premiums when insurers could discard sicker customers. The law’s requirements that insurers take everybody have made it possible for many sick people to buy full coverage for the first time. They have also meant that beneficiaries of the old system have higher prices and in some cases, pared-back coverage, points out The Journal.

Mr. Clinton’s solution also appeared to depart from that of many Democrats by implying a much broader role for government. “Let people buy in to Medicare or Medicaid,” he said, referring to the programs for older and low-income Americans in which the government subsidizes enrollment and largely funds medical claims through taxes and trying to control payments to health providers.

According to The Journal, GOP vice-presidential candidate Mike Pence tried to tie Mrs. Clinton and her running mate to the remarks in last Tuesday night’s debate.

“Even former President Bill Clinton calls Obamacare a crazy plan. But Hillary Clinton and Tim Kaine want to build on Obamacare. They want to expand it into a single-payer program,” he said.

At this juncture the gloves came off completely and the semi-civil tone of this particular argument flew out the window. A spokeswoman for the Democratic Senatorial Campaign Committee responded, in part, by trying to return to the issue of Mr. Trump’s suitability for office.

“As President Clinton noted, the healthcare bill has expanded coverage to millions of Americans and we should focus on continuing to make it better and fix the law–not the GOP’s strategy of taking it away. We wonder when Republican candidates will explain why they’re supporting a nominee they don’t believe should serve as a role model for our kids but who should hold the nuclear codes,” said Lauren Passalacqua, the committee’s national press secretary.

Earlier Wednesday, John Podesta, former chief of staff to President Clinton, and campaign chairman for Hillary Clinton, had also sought to set out both Clintons’ positions, according to The Journal.

“Secretary Clinton believes that the Affordable Care Act is doing great things, making sure that you can’t be denied coverage with pre-existing conditions,” he said on MSNBC. “She thinks it’s been a success and we need to continue it, we need to build on it, and I think that’s President Clinton’s position as well. That’s what he really believes and, you know, his colorful language notwithstanding.”

At a voter registration breakfast in Youngstown, Ohio, Mr. Clinton said he did support the health law’s changes to traditional insurance, saying that it “repeals the most insidious thing that affected millions of families, the ‘pre-existing condition’ ability of insurance companies not to insure people. But there are problems with it. There are problems with it. And everybody knows it,” he reiterated. The “crazy” word clearly had been excised from his lexicon.

All I can say is that perhaps Mr. Clinton is deliberately the front man on this particular issue, saying what needs to be said about Obamacare’s shortcomings, instead of Mr. Obama, himself. If questioned about Mr. Clinton’s comments, the President can always say those are his comments and his personal opinion. Not a bad strategy, perhaps.

Steve's Take: A baffling choice by #BillClinton to question the current state of #Obamacare Click To Tweet

 

But still, for such an accomplished orator, it was a baffling choice by Mr. Clinton of words to characterize the current state of Obamacare, drawing major media and voters’ attention to himself. It resulted in an unintentional, yet nonetheless worrying, substitution of the former President’s gigantic persona into a campaign where his wife should always be the most prominent actor on the national stage.

Then, later in the week, Mr. Trump said a few things.