Two big issues dogging the rollout of Obamacare have come into focus this week as the Connecticut insurance commissioner met with President Obama on the sticky question of insurers dropping health plans, and the state's exchange gave a breakdown that shows not enough young adults signing up.
Thomas B. Leonardi, commissioner of the state Insurance Department, was one of four officials from the National Association of Insurance Commissioners who told Obama and top administration aides late Wednesday afternoon that the president's fix — that states should let insurers extend old plans through 2014 if customers want them — is perilous.
Obama has a big headache and the state commissioners need to make sure they don't end up looking like the bad guys by rejecting the fix. Insurers are discontinuing plans that didn't meet Obamacare standards, forcing millions of people in the individual market to find new plans and pay higher premiums starting in January.
Obama, facing withering criticism after he promised that people could keep plans they liked, issued his "executive order" last Thursday, calling for extending pre-Obamacare plans — something some states, including Connecticut, were already doing.
That put the states in a bind because it's basically impossible to revive plans this close to Jan. 1 if they were already ended, without wreaking havoc. It's like asking the operator of MetLife stadium to build a dome now, in time for February's Super Bowl.
Leonardi and the others, in a conference call with reporters, downplayed the tension that must have marked the 50-minute Oval Office confab.
"It wasn't the president trying to persuade us or wanting to stiff-arm us," Leonardi said. Rather, he said, Obama wants to work with the commissioners to help them do their jobs — understanding that states are operating in different ways.
"The education of our consumers is our top priority right now," Leonardi said.
It's hard to educate people when no one knows what will, or should, happen. For example, Leonardi made the point that most complaints in Connecticut about dropped plans are from people in so-called grandfathered health plans, the ones that insurers could have kept offering even under Obamacare.
That means that at least in this state, solving the problem of dropped plans is not just a matter of loosening the rules.
Anger At Home
Clearly, there are people harmed by insurers' dropping plans that they liked and wanted to keep. How many, no one knows, because insurers are still going through the process and millions of people change coverage even in a normal year as plans cycle in and out of existence.
In Connecticut, the numbers might be fairly low. In an interview on Ray Dunaway's show on WTIC-AM 1080 radio, Leonardi estimated that it might be 27,000, but he stressed Wednesday that that figure could be off.
Leonardi and his boss, Gov. Dannel P. Malloy, are clearly under pressure at home. On Tuesday, the General assembly's top two Republicans — Rep. Lawrence F. Cafero and Sen. John McKinney, minority leaders of their chambers — fired off an angry letter saying the more likely number of Connecticut residents with dropped plans is more than 50,000.
Whatever the numbers, the problem is baked into health reform. Even if it were possible for insurers to revive and re-price plans, and for regulators to approve them, it's too late to do so by Jan. 1 without hurting a new class of people — namely the ones in plans that would have to be re-priced to reflect higher costs because of the loss of the first group.
That's what the regulators told the Obama and Health and Human Services Secretary Kathleen Sebelius on Wednesday.
"They have a better understanding of why the states have raised questions about it," said Ben Nelson, CEO of the insurance commissioners association and a former Nebraska senator. "It's obvious that the president and his staff want to work closely with the states."
The association isn't taking a position on whether states should allow the fix.
Cafero and McKinney, in their letter to Leonardi, demanded information on dropped plans and answers as to what Leonardi is going to do about Obama's proposed fix. The department is still weighing options, spokeswoman Donna Tommelleo said.
Young Adults Wanted