William Branigin and Juliet Eilperin / The Washington Post
WASHINGTON — Faced with resistance from insurers and some state officials to his health-insurance fix, President Barack Obama summoned insurance industry executives Friday for what he called a “brainstorming” session against the backdrop of widespread anxieties about how the new twist in his health-care law will be carried out.
A day after announcing a plan to delay insurance cancellations in the individual market by one year, Obama is grappling with concerns that the shift could disrupt the market and lead to higher premiums.
So far, two states — Washington and Vermont — have announced that they will not allow their health insurers to extend insurance policies that do not comply with minimum standards set by the 2010 Affordable Care Act.
Three other states — Ohio, Florida and Kentucky — announced that they would allow the renewals. At least eight states said they are trying to decide what to do in the wake of Obama’s announcement Thursday, which was intended to deal with a political furor over the cancellation of many Americans’ individual insurance policies because they do not meet the minimum requirements for coverage.
Combined with the botched rollout last month of Health Care.gov, the website for the new federal health-insurance marketplace, the policy-cancellation uproar has helped undermine Obama’s signature domestic achievement, fueling political attacks by congressional Republicans and angst among vulnerable Democrats.
In a measure of the misgivings on Capitol Hill, 39 Democrats joined most Republicans in the House in voting 261 to 157 Friday to approve a bill that would allow insurance companies to keep selling indefinitely individual health policies that do not meet the law’s basic standards. Obama has vowed to veto the bill, introduced by Rep. Fred Upton, R-Mich., and called the Keep Your Health Plan Act. The administration argues that the bill would effectively gut the ACA requirement that, beginning next year, insurance policies cover at least 10 “essential” health benefits — such as maternity care and mental health services — that often are excluded from current private insurance plans.
Speaking to reporters at the start of his meeting with insurance executives, Obama said he and top aides wanted to confer with them on ways to ensure that Americans know what kind of health coverage they can get under the law.
“What we’re going to be doing is brainstorming on how do we make sure that everybody understands what their options are,” Obama said in the Roosevelt Room. “Because of choice and competition, a whole lot of Americans who’ve always seen health insurance out of reach are going to be in a position to purchase it. And because of the law, we’re also going to be able to provide them help even if they are still having trouble purchasing that insurance. But they’ve got to know what those options are in order to be successful.”
Saying that “we know the demand is out there” for health insurance, Obama noted that “despite all the problems with the website,” more than 1 million people applied and “many multiples of that wanted to see what options were available.”
“Obviously, because of the problems with the website, some folks have been blocked from seeing the well-priced benefits that are available in the marketplace, and so we’re working 24/7 to get it fixed,” he said. “The website is working a lot better now than it was a couple of weeks ago.”
Senior White House officials, including Obama’s chief of staff, Denis McDonough, have met twice with insurance industry executives since the Oct. 1 launch of the federal marketplace to discuss its troubled rollout, and the administration consulted with some insurance companies on the president’s proposal before he announced it Thursday.
But the sudden decision to convene a meeting between the president and health-care chief executives highlighted both the level of anxiety within the insurance industry about the administration’s policy fix and the many questions that remain about how it will be carried out.
Obama said Thursday that insurance companies could continue for another year to offer to individuals and small businesses health plans that do not meet requirements under the new law, which set minimum standards for the benefits that policies must cover.
After the president’s announcement, insurers said that although they appreciate Obama’s effort to address consumer concerns, they are worried that the move could distort the risk pool in the new state and federal health-insurance marketplaces. That is because individual policies tend to be significantly more expensive than group insurance, except for customers who are young, healthy and use little medical care — the very people whom federal officials are counting on to join the new exchanges.
“Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers,” Karen Ignani, president and chief executive of America’s Health Insurance Plans, said Thursday. “If now fewer younger and healthier people choose to purchase coverage in the exchange, premiums will increase, and there will be fewer choices for consumers.”
The American Academy of Actuaries was among the groups that warned of negative effects if insurers were to keep offering those previous plans. The White House’s approach is “threatening the viability” of the new insurance marketplaces, said Corri Uccello, the academy’s senior health fellow.
State insurance commissioners and other health policy experts made clear that the landscape will vary substantially around the country.
On Thursday, Washington’s insurance commissioner criticized the president and said the state would not allow noncompliant policies to be extended beyond the end of the year.
“I do not believe his proposal is a good deal for the state of Washington,” said the insurance commissioner, Mike Kreidler. He said substandard health plans need to end to protect consumers and prevent prices from rising.
Arkansas’ insurance commissioner, Jay Bradford, said Thursday that he would not permit the extension. “At this stage, it would be too confusing to our consumers,” he said. “It would be more chaos added to an already chaotic situation.”
But Arkansas backtracked Friday, saying it was still trying to decide whether to allow the minimal policies to be extended.