Bill Clinton: Obama should honor his promise about keeping your plan if you like it

Three possibilities here. One: If you’re married to the likely Democratic nominee in 2016, it’s never too early to start running away from ObamaCare. Two: With House Republicans set to pass Fred Upton’s “Keep Your Plan Act,” Clinton wants to make sure people know that Democrats want them to keep their plans too. Three: Clinton really does believe that Obama should keep his promise. I can buy either of the first two theories but not the third, for the simple reason that … there’s no obvious way for him to keep his promise at this point. That was the takeaway from yesterday’s post. But don’t take my word for it:

The White House is “just reacting to one broken promise by imposing a much larger and harmful one: our promise to insurers that if they priced fairly, we would deliver a broad pool of insured,” [Jon] Gruber wrote in an email. “If you allow the healthy enrollees to stay out in their old policy, the insurers lose money and the program falls apart.”…

“You just can’t send tens of thousands or hundreds of thousands of ‘never mind’ letters out to policyholders on, maybe, a month’s notice,” said Robert Laszewski, a health insurance industry consultant at Health Policy and Strategy Associates. “So an executive order to change the regs would be like putting Humpty Dumpty back together.”…

Let healthy people re-enroll in their old, cheaper plans and you’re left with no way for insurers to pay for the preexisting conditions of sick enrollees that they’re now on the hook for. As for Upton’s bill:

Another insurance industry official said it would be “almost impossible to operationalize” the bill for 2014 — “bordering on herculean.”

Insurers often have to get state approval each year for their plans and premiums, which can take months. For these 2013 plans to get renewed in time for 2014, the federal government would have to circumvent state control of insurance plans — a significant change in precedent — or demand states swiftly approve the plans.

They screwed the pooch here by launching O-Care late in the year, when there isn’t time for insurers to readjust plans before new coverage takes effect on January 1. Clinton surely understands all of this too, which is why it’s interesting that he’d use a question about “if you like your plan” to urge O to keep his promise rather than try to get him off the hook by launching into some shpiel about how it’s “only” five percent who are losing their plans, how it needs to be that way to make sure the sick have coverage, etc. He’s doing Obama no favors by lending his centrist credibility to the idea that, yes indeed, getting blindsided with a cancellation notice is a legitimate grievance that the president should redress.

One last possibility, though: What if, instead of people re-enrolling in their old plans, they stayed on the new ones but got extra subsidies instead? That wouldn’t solve all of the problems with the new exchange-provided plans, like smaller provider networks, but it would make them more affordable. That’s probably a nonstarter too, though, for two reasons. First, not even Obama would presume to increase subsidies set by Congress via a unilateral executive order — I think. Second, even if he could increase the amount of subsidies himself, a couple of friends reminded me last night that the ObamaCare statute states that subsidies are available only for plans purchased on the exchange. That’s actually a fatal flaw with the “Plan B” I wrote about yesterday, wondering whether people could theoretically buy their plans directly on individual insurers’ websites. They can — but they can’t get subsidies if they go that route. You’ve got to get your plan on one of the exchanges to qualify for those. In fact, if you read the statute closely, it actually says that subsidies are available only for plans sold on state exchanges. There’s a lawsuit in federal court right now challenging subsidies for plans sold through because, after all, that’s a federal exchange, not a state one. For Obama to try to unilaterally boost subsidies despite all of that would be quite a power grab. So yeah, given his track record, it’s well within the realm of possibility that he’ll try.

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David Strom 7:01 PM on June 06, 2023