White House still projects optimism on Obamacare

The White House launched its final push for enrollment in the Affordable Care Act last week, hopeful that the beleaguered health care law can overcome runaway insurance premiums and fleeing insurers as it adds more Americans to the rolls. Sylvia Burwell, secretary of Health and Human Services, met with regional reporters at HHS headquarters Wednesday morning, moments before a major speech announcing the start of open enrollment on Nov. 1. Burwell said despite “headwinds” in achieving Obamacare’s stated goals the health care law is here to stay. “This is in the fabric of the nation,” Burwell told reporters. “We’re not going back to a place where anybody who had a pre-existing condition isn’t going to get insurance. The question is how do we go forward and make the improvements that we want to and need to make.” The Obama administration is setting its sights high for its final open enrollment period, which runs from Nov. 1 until Jan. 31, including for New Mexicans. Burwell said the administration hopes to add 13.8 million more Americans in the next three months. That’s 1.1 million more than the 12.7 million enrolled in the last open enrollment period. She also noted that anyone who signs up under the Obamacare exchanges by Dec. 15 will get their health insurance starting on Jan. 1. Obamacare has had its share of high-profile stumbles in New Mexico. Presbyterian Health Plan, the largest insurer in the state, announced in July that it would no longer offer individual and family policies on the Affordable Care Act marketplace, starting in January. The decision was expected to affect 10,000 exchange members, 80 percent of whom now receive federal subsidies, said Brandon Fryar, president of the health plan, a for-profit subsidiary of Presbyterian Healthcare Services. Meanwhile, Blue Cross and Blue Shield of New Mexico is asking for an 82 percent rate increase on its 2017 individual exchange plans after withdrawing its participation in Obamacare in 2016. The insurer pulled out of the exchange last year after being denied a 51 percent rate increase by the state’s superintendent of insurance. Nationally, one in five people who get their insurance through the exchanges now have only one option for coverage, according to an August study by the Kaiser Family Foundation. Forty-one percent of people living in rural areas will have just a single insurance option in the exchange. However, Burwell said the law has produced hundreds of billions of dollars in Medicare savings and historically low premium increases for the 157 million Americans with employer-based insurance — the bulk of those who are insured. She also said 20 million people have gained health insurance since Obama signed the Affordable Care Act into law six years ago, leading to the lowest rate of uninsured in U.S. history. Many of the 10.7 million U.S. citizens who remain uninsured are poor people, minorities or younger folks. She said HHS is reaching out to people in novel ways this year, including targeting them in churches, on their cellphones and even through new technologies such as the gaming platform Twitch and the ride service Lyft. “We think a lot of people actually don’t know (about their obligation to become insured under law) and we’re not always able to reach them,” Burwell said, adding that 85 percent of those who enroll on the exchange qualify for subsidies in the form of tax breaks. “What we want to do is reach the right people with the right message at the right time.” All four Democrats in New Mexico’s delegation supported Obamacare at the time of its inception and they all support retaining it, although they concede that the law needs to be tweaked to deal with steep premium increases, a lack of insurer access and other problems. Burwell said in states like New Mexico, which expanded Medicaid, premiums tend to be lower. “It does tend to work better in places where there’s support,” she said. “In states that have expanded Medicaid, it’s estimated premiums will be 7 percent lower in marketplace.” But she also acknowledged that problems persist in New Mexico and elsewhere. “Have we had challenges — sure,” Burwell said, noting wryly the technology glitches that turned Obamacare’s initial rollout into a disaster. “It’s a complicated thing.” One thing is certain: The debate over the controversial health care law isn’t going away, no matter how optimistic the Obama administration remains about it in its waning days. “Doubling down on disaster is not a solution,” wrote Jim DeMint, a former U.S. senator who now heads the conservative Heritage Foundation in Washington, in an op-ed this month. “Rather than try to prop up an ill-designed law, Congress needs to systematically repeal and replace Obamacare’s dysfunctional policies with more sensible solutions, starting with the law’s most damaging provisions.”