This week marked the six-month anniversary of the health law’s passage and a number of its consumer protections took effect. Based on news coverage, the attention to this milestone had policy and political implications, six weeks before the midterm elections.
One of the new rules, according to Kaiser Health News, “bars insurers from denying coverage of children up to 19 with preexisting medical conditions.” This change is designed to address the fact that “[f]or years, insurers – principally those in the individual insurance market – have denied coverage to children, as well as adults, with medical conditions. In some cases, they have accepted them but refused to cover their preexisting conditions for a set period. Now, such practices are banned for children, and will be prohibited for adults in 2014. The Department of Health and Human Services, which is writing the regulations implementing the law, estimates that 31,000 to 72,000 uninsured children with preexisting conditions will gain coverage due to the provision between now and 2013” (McGinley and Carey, 9/23).
The New York Times fleshed out a number of the changes, including a prohibition on insurers from imposing lifetime limits on benefits. In addition, the overhaul “requires that they offer coverage to children under 26 on their parents’ policies. It establishes a menu of preventive procedures, like colonoscopies, mammograms and immunizations, that must be covered without co-payments. And it allows consumers who join a new plan to keep their own doctors and to appeal insurance company reimbursement decisions to a third party.” The provisions go into effect right before Democrats start their push to keep control of Congress (Sack, 9/22). The Associated Press provided more detail: “The list includes tests strongly recommended by the U.S. Preventive Services Task Force, an independent advisory panel that evaluates research.” AP also included the actual list of the services that will be available for free to everyone with insurance (Johnson, 9/22). And NPR outlined how the rules include “a ban on most so-called rescissions. That’s the insurance industry practice of revoking an insurance policy retroactively, after a policyholder has racked up hefty medical bills. … At a congressional hearing last year … the CEOs of several insurance firms said they had basically no choice but to rescind some policies, at least until everyone is required to have health insurance” (Rovner, 9/23).
As the Obama administration was holding public events throughout the week to celebrate these protections, the insurance industry appeared to take steps to cut their losses. The Washington Post reported that “[s]ome of the country’s most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply” with the rules. WellPoint, Cigna and CoventryOne are among the insurers that will end the plans. The insurers cited “uncertainty in the health insurance market” as the reason behind these decisions, but health reform advocates viewed this action as “an end run” around a key consumer protection (Aizenman, 9/20). The Hill noted the “fierce push-back” that ensued “from the administration’s allies” in response (Pecquet, 9/20).
(Check KHN’s Guide To September 23 for more detailed coverage of the policy changes now in effect.)
The occasion also offered President Obama a public relations opportunity on the health law, which has not proven to been the political boon its backers predicted it would be, according to The Washington Post: “Six rocky months after winning passage of the landmark health-care law, President Obama celebrated the half-year mark by holding a sunny backyard get-together in the Virginia suburbs with a sampling of Americans from across the country who he said are already benefitting. With polls showing the public ambivalent about the law, and Democrats in some districts taking a beating for supporting it, many prefer to keep the focus on jobs and other economic issues. The president, too, seemed keen to counter the belief of some that health care distracted him from what many voters view as the most pressing concern: turning around the economy” (Aizenman and Kornblut, 9/23). The Christian Science Monitor bottom-lined the difficult political dynamics the law’s suporters now face. “Taken separately, all [the provisions that go into effect today] are popular. But opponents of so-called ‘Obama-care’ have pounded away at the individual mandate to carry coverage (the subject of the lawsuits) and various fears: that people will be forced to change doctors, that the cost of health-care premiums will skyrocket, and that the cost of reform will burden the federal government with higher deficits and debt” (Feldmann, 9/22).
The Associated Press, in a poll released earlier in the week, found that Americans continue to be confused by the health law’s provisions. “Many who wanted the health care system to be overhauled don’t realize that some provisions they cared about actually did make it in. And about a quarter of supporters don’t understand that something hardly anyone wanted didn’t make it: They mistakenly say the law will set up panels of bureaucrats to make decisions about people’s care – what critics labeled ‘death panels.'” The confusion is hurting efforts by the Obama administration to sell the law and is endangering Democrats in Congress who face re-election fights this fall” (Alonso-Zaldivar and Tompson, 9/21).
Politico examined an array of polls to get a better sense of public opinion. “Six months after President Barack Obama signed the Democrats’ bill into law, more Americans still oppose it than support it – and a relatively smooth implementation process has done virtually nothing to change the negative feelings that arose during the long legislative debate. According to Pollster.com’s aggregate look at polling data, 49 percent of Americans oppose the law, while just 41 percent support it” (Kliff and Haberkorn, 9/22). And NPR noted that it “appears the political benefits of the measure have yet to materialize for the White House. The administration assumed and many political analysts did too, that once people got to know what was in the law, the measure would become more popular. … Democrats, who were assured their vote for the law would help them this fall, are not campaigning on it. Only those Democrats who were against it are calling attention to their votes” (Liasson, 9/22).
(KHN’s Daily Report on 9/20, 9/22, 9/23 and 9/24 tracked the coverage related to the political issues related to the health bill and the changes that took effect on Thursday.)