White House Announces New Delays, Changes to ACA

On Wednesday, the Obama administration announced a series of new delays and changes to the Affordable Care Act, including a two-year extension of an administrative fix allowing individuals to keep health plans that do not meet the law's minimum coverage standards, the Washington Post reports (Goldstein/Somashekhar, Washington Post, 3/5).

Background

President Obama initially issued the administrative fix in November 2013, following reports that millions of U.S. residents were being notified by their insurers that their existing health policies will be discontinued in late 2014 because they do not meet minimum standards under the ACA.

Under the fix, insurers are allowed to continue selling such health policies, but they are required to inform consumers that more comprehensive coverage options might be available in the ACA's insurance exchanges. Insurers also have to list the benefits that affected consumers would be going without if they choose to keep their current policies

California Insurance Commissioner Dave Jones (D) urged Covered California to implement Obama's proposal.

However, Covered California's board unanimously decided not to allow insurers to continue selling policies that do not meet the ACA's minimum coverage requirements.

In a statement, the board said that "extending the deadline offers no benefit to the consumer and may create confusion about accessing affordable health care coverage" (California Healthline, 11/22/13).

Extension of Administrative Fix

The extension will now allow people to renew such plans until 2016, with coverage lasting in some cases until September 2017.

According to an administration official, congressional budget analysts have estimated that nearly 1.5 million U.S. residents currently have plans that do not meet the ACA's minimum requirements. However, since people can renew the plans but are no longer allowed to make new purchases of such plans, the number of individuals with such coverage will be small by 2016 (Goldstein/Somashekhar, Washington Post, 3/5).

Other ACA Changes

The administration also announced a variety of other changes to the ACA, including:

• Extending the 2015 open enrollment period for the health insurance exchanges by one month, ranging from November 2015 to February 2015;
• Allowing states more time, until June 15, to determine whether they will operate their own exchanges in 2015;
• Increasing annual limits on cost-sharing -- such as copayments, co-insurance and deductibles -- in 2015 (Agnes Carey, Kaiser Health News, 3/6);
• Delaying for an additional year a requirement that small employers offer workers a range of coverage options (Harrison, "On Small Business," Washington Post 3/5); and
• Lowering the threshold for which insurers can qualify for so-called risk corridors created under the law in 2015.

However, the administration noted that the open enrollment period for this year would not be extended past the March 31 deadline.

Meanwhile, the administration issued rules for employers with at least 50 employees who must begin offering full-time workers health coverage under the law, including reporting requirements.

Reaction

Republicans denounced the changes. House Committee on Oversight and Government Reform Chair Darrell Issa (R-Calif.) called extending the administrative fix "a cynical ploy that delays thousands of insurance policy cancellations until after" the upcoming midterm elections (Goldstein/Somashekhar, Washington Post, 3/5).

Sen. John Thune (R-S.D.) added, "Each and every delay of [the ACA] is an admission that the Democrats' signature law is hurting Americans and an obvious attempt to try to save the jobs of vulnerable congressional Democrats come November" (Radnofsky, Wall Street Journal, 3/5).

Meanwhile, America's Health Insurance Plans President and CEO Karen Ignagni in a statement said that the extension "could lead to higher premiums for those consumers [who] remain in the exchanges" because it "allows more young and healthy individuals to choose not to" purchase exchange plans (Kaiser Health News, 3/6).

In addition, legal experts have questioned whether the changes are an overreach of the president's authority. George Washington University law professor Jonathan Turley said, "[W]hat the president is doing is effectively amending or negating the federal law to fit his preferred approach." He added that the move sets a precedent that future presidents could also use to delay other portions of the ACA or additional laws.

Sebelius Defends Changes

HHS Secretary Kathleen Sebelius said the changes were intended to "smooth the transition" to the new system created under the ACA. The administration acknowledged that the fixes could result in "higher average claims costs" for people who purchase plans that comply with ACA standards but said the law contains "shock absorbers" to help stabilize premium prices (Pear, New York Times, 3/5).