Under this president, even if you like the law of the land, you can’t keep it. His administration, no stranger to ignoring or refusing to enforce pages of the Federal Register, is now rewriting another key part of the Affordable Care Act to escape the political fallout from the insurance cancellations that are an integral part of its design.
Using its preferred legislative tool, lawless executive decree, the administration has decided not to enforce some of Obamacare’s costly mandates in 2014, allowing insurance companies, in theory, to renew plans that don’t meet them. Insurers may cancel many of the plans anyway on grounds it is too complicated and expensive to go back now, and state insurance regulators may not want to backtrack, either. Washington State has already suggested it will ignore the “fix” and follow the ACA’s regulations. Surely this is the reaction the White House is hoping for, so it can give lip service to addressing cancellations without truly changing anything, and so it can blame someone else — the insurers, state regulators — for the consequences of its own law.
The White House knows that the viability of the exchanges depends on younger, healthier people getting forced out of their plans and onto the exchanges. As the president admitted in his press conference yesterday, he realized at the time that his promise about keeping your insurance wouldn’t apply to everyone, and he is giving insurers only a brief escape hatch because he ultimately needs and wants “non-compliant” policies canceled — despite his infamous promise and despite his semi-apologies about it now.
If sufficient political pressure is brought to bear on insurers, though, they may well let enough people keep their current plans to further undermine the Obamacare exchanges that are already suffering from tiny enrollment figures. Many of the canceled policies continue through the end of the year — in other words, people are still on them — and there are waves of cancellations that haven’t occurred yet. The insurance industry understandably feels as though it is getting yanked back and forth, but excuse us if our sympathy is limited: The insurers got into bed with Obamacare and are still invested in the exchanges and their promised federal subsidies.
The president felt compelled to offer his “fix” to stop a Democratic stampede in favor of grandfathering legislation proposed by Representative Fred Upton in the House. The bill would allow insurance companies to offer plans eliminated by Obamacare for another year and allow them to sell the plans to people who don’t already have them. Some on the right are skeptical of the bill because it repairs rather than repeals Obamacare, but it would really be a step toward dismantling. It would keep people from and draw them out of the exchanges, and were it to become law, the pressure to renew it after the first year would be irresistible. If the president had lost 100 Democrats’ votes to the Upton bill, it could have effectively been the end of the Obamacare coalition in Congress. Hence the urgency to offer his “fix.”
There is only one true fix worthy of the name, of course: repeal and replace. The president’s move yesterday was cynical and lawless, but we should take heart. We have been told again and again that Obamacare is inevitable and that resistance is pointless and irrational. Yet it is the defenders who are on the run.