President Obama’s messy breakup with insurers - David Nather - POLITICO.com

Obama has had a love-hate relationship with insurers since the debate started. | AP Photo

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President Barack Obama is breaking up with the health insurance industry again.

He’s had a love-hate relationship with the insurers ever since the early days of the health care reform debate. He yelled at them in public for giving people skimpy coverage, then slipped them a gift-wrapped box of chocolates — the individual mandate they wanted to gain millions of new customers.

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Even during the implementation of Obamacare, he has stuck with the industry, staying in the rocky relationship despite all the petty bickering. He has to use them as a foil to advertise the law’s benefits, like all the rebates from greedy insurance companies. But he also needs them to make the law work — which is why he has been careful not to raise his voice at them even as they sent cancellation notices to individual insurance customers throughout the country.

Now, Obama is putting them on the spot. The message of his proposed one-year fix to the cancelled policies is this: I’m giving you a chance to clean up the mess. If you don’t clean it up, don’t blame it on me.

“The bottom line is insurers can extend current plans that would otherwise be cancelled into 2014,” Obama said at his Thursday press conference.

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Industry CEOs have been summoned to a White House meeting Friday that’s sure to be full of those awkward conversations about who did what to whom, and who’s being unreasonable this time.

It’s enough to stress a relationship to the breaking point. And breaking up, as the song goes, can indeed be hard to do - and in the case may have implications for innocent bystanders, such as health care customers.

“The president was clear as a bell: ‘We’ve done our part. If rates go up or anything, that’s not our fault.’ And that’s not the case,” said Bill Pierce, a former Department of Health and Human Services official who has also worked in the health insurance industry.

Democrats badly needed a fix to point to on Friday, when they'll have to vote on a Republican bill to let all Americans keep their health plans. But the need to give Democrats political cover can’t justify a change that could backfire in other ways, Pierce said.

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“It is a political solution to a policy problem … You cannot solve a policy problem with a political solution,” said Pierce, now a senior director at APCO Worldwide.

Sure, there was a bit of “it’s not you, it’s me” in Obama’s press conference Thursday. “That’s on me. I mean, we fumbled the rollout on this health care law,” Obama said.

But really, insurers, it’s you.

“What we want to do is to be able to say to these folks, you know what, the Affordable Care Act is not going to be the reason why insurers have to cancel your plan,” Obama said.

There’s just one problem: Health insurers say the fix won’t work. And state insurance commissioners and leading actuaries aren’t sure, either.

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For one thing, health insurance plans already set their prices for the Obamacare plans assuming that they’d get a certain number of customers, and the right mix of healthy and sick people. If they don’t get those people, they’re warning that the mix will be thrown off, and prices will have to go up — creating a new nightmare for the administration.

“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 Ignagni of America’s Health Insurance Plans, the leading health insurance trade group, said in a statement.

Health insurance actuaries echoed the alarm.

“Changing the [Affordable Care Act] provisions could alter the dynamics of the insurance market, creating two parallel markets operating under different rules, thereby threatening the viability of insurance markets operating under the new rules,” said Cori Uccello, the senior health fellow at the American Academy of Actuaries.

http://www.politico.com/story/2013/11/barack-obama-health-insurers-obamacare-affordable-care-act-99900.html