Obama seeks cure for health care law’s ‘grow­ing pains’

The Washington Times Weekly - - Politics - BY TOM HOW­ELL JR.

Pres­i­dent Obama fiercely de­fended his sig­na­ture health law Thurs­day, say­ing it’s slashed the unin­sured rate to his­toric lows, though he im­plored his suc­ces­sor and Congress to cure the “grow­ing pains” that have bat­tered the pro­gram po­lit­i­cally and left mil­lions of unin­sured on the side­lines.

Say­ing no law is per­fect, Mr. Obama said the Af­ford­able Care Act cov­ered more than 20 mil­lion peo­ple, but that some Amer­i­cans will face ris­ing pre­mi­ums and mea­ger choices on the law’s web-based ex­changes, which failed to at­tract the right mix of cus­tomers in the early rounds.

Yet re­peal­ing the law isn’t the an­swer, the pres­i­dent warned, as he urged law­mak­ers to build on his re­forms af­ter he leaves of­fice in Jan­uary.

“I don’t care about credit. I just want it to work be­cause I care about the Amer­i­can peo­ple and mak­ing sure they’ve got health in­surance,” Mr. Obama told stu­dents at Mi­ami Dade Col­lege in Florida.

Oba­macare sign-ups for 2017 start Nov. 1, and Mr. Obama knows the fi­nal en­roll­ment period of his ten­ure will be crit­i­cal to the fate of his law, as in­sur­ers cry foul over a crush of costly cus­tomers and the healthy con­sumers who could im­prove the com­pa­nies’ ledgers balk at the re­sult­ing rate hikes.

He said, for most cus­tomers, in­come-based sub­si­dies will ab­sorb the ris­ing costs of 2017 plans that will be avail­able on the ex­changes through Jan. 31. But he said Congress should think about ex­tend­ing those sub­si­dies to more peo­ple, since bud­get-min­ders say the tax cred­its haven’t cost tax­pay­ers as much as ex­pected.

Mr. Obama im­plored Repub­li­can law­mak­ers in 19 hold­out states to ex­pand Med­i­caid, the govern­ment-run in­surance pro­gram for the poor, to those mak­ing 138 per­cent of the fed­eral poverty level so that an ex­tra 4 mil­lion Amer­i­cans peo­ple would be cov­ered.

And he pushed Capi­tol Hill to con­sider a gov­ern­men­trun plan, or “public op­tion,” to bol­ster com­pe­ti­tion un­der his pro­gram.

Mr. Obama is hoping to hand the keys to his sig­na­ture law to Demo­cratic pres­i­den­tial nom­i­nee Hil­lary Clin­ton, who’s vowed to de­fend and build on the law if she wins in Novem­ber. She too wants to pro­vide the public op­tion that Mr. Obama en­dorsed.

Yet Repub­li­cans say dou­bling down or ex­pand­ing the pro­gram will only ex­ac­er­bate the pro­gram’s stum­bles.

“Af­ter lis­ten­ing to the pres­i­dent’s speech, I’m not sure what health care law he’s talk­ing about,” House Speaker Paul D. Ryan said. “He wondered out loud why there’s been such a fuss. It’s no se­cret: It’s be­cause of Oba­macare.”

Ma­jor in­sur­ers such as Unit­edHealth Group and Aetna are flee­ing the ex­changes, cit­ing heavy losses, while in­sur­ers who re­main say dou­ble-digit rate hikes are needed to im­prove their ledgers af­ter Oba­macare’s car­rots and sticks failed to prod enough young peo­ple into the pro­gram dur­ing the early rounds.

That’s be­cause mil­len­ni­als are ef­fec­tively be­ing asked to sub­si­dize older cus­tomers, Oba­macare’s crit­ics charge, since in­sur­ers can­not charge their old­est en­rollees more than three times what they charge their youngest cus­tomers.

The ad­min­is­tra­tion says it will urge young peo­ple to sign up for 2017 through so­cial me­dia, a bet­ter brows­ing ex­pe­ri­ence on smart­phones and tar­geted mail­ers from the IRS to those who paid a tax penalty for choos­ing to re­main unin­sured.

As it stands, Health and Hu­man Ser­vices Sec­re­tary Sylvia Mathews Bur­well es­ti­mates that 13.8 mil­lion peo­ple will buy plans in 2017 dur­ing open en­roll­ment on the ex­changes, com­pared to 12.7 mil­lion who ini­tially signed up for 2016.

That’s still short of the 15 mil­lion that con­gres­sional score­keep­ers pre­dicted just a few months ago, and some an­a­lysts say it is an op­ti­mistic goal that, even if achieved, would help to sta­bi­lize the mar­ket but fall short of what’s needed to put the law on firm eco­nomic foot­ing.

Robert Laszewski, a health con­sul­tant from Alexan­dria, Vir­ginia, said the ad­min­is­tra­tion seemed in­tent on gen­er­at­ing pos­i­tive head­lines ahead of the elec­tion.

“I do not see any ma­te­rial im­prove­ment in the risk pool next year,” he said. “Pre­mi­ums are higher, de­ductibles are higher, and net­works are nar­rower. There are fewer car­rier choices. Ev­ery­thing is worse for the con­sumer than it was last year. How do you get a bet­ter re­sult?”

Mr. Ryan says it isn’t pos­si­ble, so Congress should re­place Oba­macare’s govern­ment man­dates and cov­er­age re­quire­ment with free mar­ket in­cen­tives de­signed to en­tice cus­tomers into pri­vate mar­ket plans.

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