STATES

The Washington Times Daily - - Pol­i­tics - — Florida In­sur­ance Com­mis­sioner Kevin M. McCarty

The White House con­tin­ues to grap­ple with the poor roll­out of the pres­i­dent’s sig­na­ture pro­gram. On Mon­day, a spokesman said the ad­min­is­tra­tion is unlikely to meet its self-im­posed Nov. 30 dead­line to have the Health­Care.gov web­site fully func­tional and that a 80 per­cent suc­cess rate is now the best hope.

Among the other 20 per­cent, White House spokesman Jay Car­ney said, are those who aren’t com­fort­able en­rolling on­line or who have per­sonal cir­cum­stances that are too “com­plex” to use the web­site.

Other pro­vi­sions of Oba­macare that are rankling Amer­i­cans in­clude min­i­mum-cov­er­age re­quire­ments and whether large em­ploy­ers should pay for con­tra­cep­tives.

But the big­gest headache stems from the mil­lions of con­sumers in the in­di­vid­ual mar­kets whose poli­cies have been can­celed in re­cent months. In­sur­ance com­pa­nies say these plans don’t meet Oba­macare’s long list of re­quire­ments.

Mr. Obama, who dur­ing the health care de­bate said Amer­i­cans could keep their plans if they liked them, was forced to back­track and an­nounce the use of ex­ec­u­tive au­thor­ity to let states de­cide whether poli­cies should be can­celed.

The move may have cost the job of the D.C. in­sur­ance com­mis­sioner, who said a one-year re­prieve for bare-bones plans on the in­di­vid­ual market could un­der­cut the health care over­haul.

Other com­mis­sion­ers are still on the pay­roll, try­ing to keep up with shift­ing rules while the Obama ad­min­is­tra­tion scram­bles to smooth out the rocky im­ple­men­ta­tion of the pres­i­dent’s sig­na­ture law.

Sara Rosen­baum, a pro­fes­sor of law and health care pol­icy at George Wash­ing­ton Univer­sity, said Mr. Obama’s move to give states the fi­nal de­ci­sion is “con­sis­tent with the Af­ford­able Care Act it­self,” whose au­thors wanted to let states set up their own mar­kets and guide­lines.

But the line be­tween state and fed­eral re­spon­si­bil­i­ties for Mr. Obama’s over­haul has blurred over the past three years, partly be­cause of re­luc­tant Repub­li­can gov­er­nors and a Supreme Court that said states could opt not to ex­pand Med­i­caid un­der the law.

In Florida, Mr. McCarty said, some in­sur­ance com­pa­nies vol­un­tar­ily ex­tended cov­er­age for af­fected pol­i­cy­hold­ers through 2014 — an early-bird strat­egy to head off Oba­macare stan­dards that take ef­fect Jan. 1.

The state’s largest in­surer, Florida Blue, did not make such ac­com­mo­da­tions, so Mr. McCarty promised to work with the com­pany to re­new poli­cies.

“It’s very frus­trat­ing to be in a sit­u­a­tion where, quite frankly, the prob­lems were ex­ac­er­bated by the fum­bles of the [Obama] ad­min­is­tra­tion in get­ting out the pro­gram of Health­Care.gov,” he said.

In Wash­ing­ton — one of the 15 states that em­braced the health care re­form and set up their own ex­changes — In­sur­ance Com­mis­sioner Mike Krei­dler said in­sur­ers would not be able to re­new plans that flout Oba­macare. He said such a move might desta­bi­lize the state-run health care ex­change, which is work­ing rel­a­tively well, by al­low­ing young, healthy peo­ple to stay on low-level plans in­stead of en­rolling in the Oba­macare market.

Ken­tucky’s in­sur­ance com­mis­sioner, Sharon P. Clark, said Mon­day that she doesn’t fear tu­mult in her state’s in­di­vid­ual market over Mr. Obama’s plan, even though her state also boasts a high-per­form­ing ex­change.

Like Florida, her state al­lowed in­sur­ers to ex­tend plans into 2014 in­stead of risk­ing can­cel­la­tion un­der Oba­macare. She said other states might be hav­ing dif­fi­cul­ties “be­cause they might not have had the al­lowance for early re­newal.”

Cal­i­for­nia In­sur­ance Com­mis­sioner Dave Jones is en­cour­ag­ing in­sur­ers to let res­i­dents keep their health plans in the com­ing year. He said roughly 1 mil­lion res­i­dents with can­celed plans should have the free­dom to re­new their plans in line with Mr. Obama’s orig­i­nal prom­ise or shop for al­ter­na­tive plans on Cov­ered Cal­i­for­nia, the state’s ex­change.

While he awaits feed­back from in­sur­ers, he has found some can­cel­la­tion no­tices that in­clude er­rors, ef­fec­tively al­low­ing some cus­tomers to keep their ex­ist­ing cov­er­age un­til the end of March.

He does not think the pro­posed re­newals will cause tu­mult in the state ex­change’s sta­bil­ity, since there are safe­guards within the law to deal with ad­verse changes to the risk pool. Ad­di­tion­ally, es­ti­mates show that up to 400,000 Cal­i­for­ni­ans could be el­i­gi­ble for sub­si­dies to de­fray their pre­mi­ums, mak­ing the ex­change more at­trac­tive.

“These con­cerns about im­pacts on the ex­change are ex­traor­di­nar­ily mis­placed … Peo­ple are very price-sen­si­tive. We’re en­cour­ag­ing peo­ple to shop,” he said.

Of­fi­cials in Ten­nessee and other states are try­ing to un­der­stand the long-range im­pact of Mr. Obama’s pro­posal and haven’t de­cided one way or the other.

“The gover­nor and com­mis­sioner’s pri­mary goal is to max­i­mize Ten­nesseans’ op­tions in the evolv­ing health in­sur­ance mar­ket­place,” said Alexia Poe, spokes­woman for Gov. Bill Haslam, a Repub­li­can. “They also be­lieve that Ten­nesseans should be able to keep the cov­er­age they were as­sured they’d be able to keep.”

“It’s very frus­trat­ing to be in a sit­u­a­tion where, quite frankly, the prob­lems were ex­ac­er­bated by the fum­bles of the [Obama] ad­min­is­tra­tion in get­ting out the pro­gram of

Health­Care.gov.”

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