GOP Shifts Attention From Glitches to Insurance ‘Cancellation’ Letters
On Tuesday, Republicans launched a new volley of criticism against the Affordable Care Act amid a media report that millions of U.S. residents with individual health policies nationwide are receiving notifications from insurers that their coverage will soon end, AP/U-T San Diego (Alonso-Zaldivar/Ohlemacher, AP/U-T San Diego, 10/29).
Background
On Tuesday, NBC News reported that millions of consumers nationwide have received -- or are expected to receive -- such notifications from their insurers because their current policies do not meet the minimum coverage requirements.
Four unidentified individuals who helped develop the ACA told NBC News that between 50% and 75% of the estimated 14 million people who have coverage on the individual market could expect to receive the "cancellation" notices or similar letters over the next year. One expert -- Robert Laszewski, a consultant at Health Policy and Strategy Associates -- estimates that figure could reach 80%. According to NBC News, all the sources agreed that many of the consumers would be required to buy more costly coverage and could experience "sticker shock."
Under the ACA, insurance policies that were in effect as of March 23, 2010 -- when the law was enacted -- will be "grandfathered" even if they do not meet the new coverage requirements. HHS later issued regulations clarifying that if any of those plans were changed significantly after that date, they would lose their grandfathered status.
Language in ACA regulations dated July 2010 estimates that "40 to 67%" of consumers will lose their health policies, indicating that the Obama administration knew that millions of people would lose their coverage, according to NBC News. However in 2012, President Obama said, "If [you] already have health insurance, you will keep your health insurance." He had made a similar pledge in 2009, saying, "[I]f you like your health plan, you will be able to keep your health plan" (California Healthline, 10/29).
Cancellation Letters Details
According to the New York Times, the report of the cancellation letters has helped broaden the GOP's platform for its attacks against the ACA. The issue also has helped add another layer to Republicans' criticism of the problem-plagued launch of the federal health insurance exchange, the Times reports. Some GOP lawmakers privately have expressed concern that their scrutiny of the exchange will eventually lead to a dead end once the issues with the HealthCare.gov portal are resolved (Weisman/Pear, New York Times, 10/29).
Citing the emerging issue of the cancellation letters, House Speaker John Boehner (R-Ohio) on Tuesday said, "You know, the problem with Obamacare isn't just the website; it's the whole law." He added, "I've heard from hundreds of my constituents who are seeing their premiums rise. They're seeing their policies being canceled" (Madhani, USA Today, 10/30).
Two other House Republican leaders echoed Boehner's sentiments, with a focus on the letters.
After a House GOP caucus meeting, Majority Leader Eric Cantor (R-Va.) reiterated that the policy cancellations conflict with Obama's repeated promises. As he held up one such letter that a Virginia constituent received from Anthem Blue Cross Blue Shield, Cantor said, "If the president knew these letters were coming and still indicated that you could keep your health care plan if you liked it, now that raises some serious questions about the sales job of Obamacare."
During a House Ways and Means Committee hearing, Budget Committee Chair Paul Ryan (R-Wis.) said the letters indicate that consumers will continue to receive these "rude awakenings" as the health reform law is implemented (Easley/Sink, "Healthwatch," The Hill, 10/29).
Tavenner: Cancellations Not an Effect of ACA
During the Ways and Means Committee hearing -- which primarily focused on the troubled rollout of the federal insurance exchange -- CMS Administrator Marilyn Tavenner pushed back against Republicans' questioning about the letters and defended Obama's previous promises to consumers, the National Journal reports. She also stressed that the cancellations were taking place before the ACA was enacted (Novack, National Journal, 10/29).
Tavenner said, "Half of the people in the individual market prior to 2010 didn't stay on their policies," adding, "They were either kicked off for pre-existing conditions, they saw their premiums go up at least 20% a year, and there were no protections for them. And sometimes they were in plans that they thought were fine until they actually needed hospitalization, and they found out it didn't cover hospitalization or it didn't cover cancer" (USA Today, 10/30).
Tavenner noted that some of the cancellations occurring now are the result of insurers changing the plans they offer, which makes them ineligible to be grandfathered into the market in 2014. She added that the changes often are being made to bolster plans' benefits to include new protections under the ACA, such as not discriminating against individuals with pre-existing conditions (National Journal, 10/29).
White House, House Dems Play Defense
Meanwhile on Tuesday, White House press secretary Jay Carney dismissed claims that Obama intentionally misled the public when he assured people that they could keep their existing policies under the ACA, The Hill's "Healthwatch" reports.
Carney said that consumers who "had a plan the day before the [ACA] passed and signed into law" and who had not either dropped their coverage or "been thrown off the plan" by their insurance companies were "grandfathered in and can keep that plan." He added, "If you've kept it, you can keep it forever, as long as your insurer offers it" (Sink, "Healthwatch," The Hill, 10/29).
During a press briefing on Capitol Hill, House Minority Whip Steny Hoyer (D-Md.) on Tuesday said that while some Democrats were aware that some consumers would be forced off their plans, he argued that those individuals would ultimately benefit by getting better insurance and that many of them would pay less than they do now, The Hill's "Healthwatch" reports.
Hoyer said, "We've used that [message] in trying to allay the fears of people who have group policies or significant coverage … through their employer, which was the overwhelming number." He added, "I think we could have caveated [to say], 'Unless you have coverage that's insufficient to accomplish the objectives of giving you adequate, quality health care'" (Lillis, "Healthwatch," The Hill, 10/29).
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