The Los Angeles Times by Noam N. Levey –
April 30, 2013:
President Obama sought to tamp down fears Tuesday that his landmark healthcare law would raise insurance costs and cause other disruptions, saying most Americans were already benefiting from it and others soon would.
“Any time you’re implementing something big, there’s going to be people who are nervous,” the president said at a news conference at which he delivered a new pitch for the 2010 legislation. “For the average American out there, for the 85 and 90% of Americans who already have health insurance, this thing’s already happened.”
Key parts of the law have been implemented, including a provision allowing people in their early 20s to remain on their parents’ health plans and requirements that insurers offer preventive benefits such as physical exams and cancer screenings without co-payments.
Referring to Americans enrolled in plans, Obama said, “Their insurance is more secure.”
But the law’s signature benefit — a guarantee that all Americans can get insurance, even if they are ill — doesn’t take effect until next year. Building a system to deliver on that promise has been the law’s most complex and costly challenge.
The Obama administration is now scrambling, as are some states, to set up state-based insurance marketplaces so that, beginning in October, Americans who do not get health benefits through work will be able to select a plan for coverage in 2014.
Administration officials are also working to persuade states to expand their Medicaid programs next year to cover low-income Americans on the government health insurance plan. The law’s supporters hope these coverage expansions will extend health insurance to as many as 30 million people over the next decade.
But Republican opposition to the law, delays in issuing key regulations and persistent public confusion have fueled growing nervousness among some supporters, including Democrats on Capitol Hill.
Last month, Senate Finance Committee Chairman Max Baucus (D-Mont.), a leading architect of the law, told Health and Human Services Secretary Kathleen Sebelius that he feared a “train wreck” when online exchanges open this fall to sell health insurance to consumers.
Adding to the anxiety are warnings from insurers that requirements in the law will force them to dramatically increase premiums for consumers who buy insurance on their own or get it through a small business. Millions of consumers are expected to qualify for federal subsidies.
Although most 2014 rates have not been issued yet, CareFirst BlueCross BlueShield shocked many observers recently by proposing to raise premiums for individuals who buy insurance on their own in Maryland by an average of 25%. The proposed rate hike is now under review by state regulators.
“The alarm bells over how Obamacare will unfold are getting louder by the day: Costs are going up, insurers are warning about premium increases, and small businesses are struggling with the choice about whether they can provide employees with coverage,” House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) warned last week at a congressional hearing.
Administration officials are trying to calm anxieties about what will happen next year, in part by publicizing the law’s benefits and showcasing their efforts to sign up uninsured Americans this fall. Enrolling young, healthy Americans is widely seen as crucial to the law’s success, in large part because their typically low medical costs help keep down premiums for others.
The administration is working to encourage enrollment with the help of a coalition of consumer groups, medical associations and leading healthcare companies, such as CVS Caremark and Aetna. Also aiding the effort is Organizing for Action, the nonprofit advocacy group backing Obama’s legislative agenda.
Obama pledged that the administration would meet all its deadlines and make the process as smooth as possible. He cited the release Tuesday of a simplified enrollment form for individual insurance, which was reduced to three pages from a 21-page draft.
“There’ll still be, you know, glitches and bumps…. That’s pretty much true of every government program that’s ever been set up,” Obama said. “But if we stay with it, and we understand what our long-term objective is, which is making sure that in a country as wealthy as ours, nobody should go bankrupt if they get sick, and that we would rather have people getting regular checkups than going to the emergency room because they don’t have healthcare, if we keep that in mind, then we’re going to be able to drive down costs.”
That message does not appear to have reached wary Americans. Support for the Affordable Care Act dipped again last month, with just 35% reporting a favorable view in the latest poll by the nonprofit Kaiser Family Foundation.
More than 4 in 10 Americans do not know that the law is in effect, the survey found.