In an effort to appease a frustrated public and rebellious party, President Obama introduced a “fix” to the Affordable Care Act Thursday, allowing insurers to provide existing customers health care plans that had been cancelled for next year. But the executive action only temporarily stifled the revolt in the Democratic Party without changing much the underlying conditions of their anger. Among Capitol Hill Democrats Thursday, there was open discussion of breaking with the president, a stunning turnaround from last month, when the party remained firmly united to defend Obamacare during the 16-day partial government shutdown.
“The current state of the system is absolutely unacceptable and this is a start,” said Sen. Richard Blumenthal (D-Conn.). “I think there’s a lot of support for additional changes that require legislation.”
Sen. Mary Landrieu (D-La.), Sen. Mark Udall (D-Colo.) and Rep. Fred Upton (R-Mich.) have introduced legislation that would go far beyond the president’s limited effort to allow insurers to continue low-quality health insurance plans that are supposed to be banned under the healthcare law. Landrieu’s bill requires insurers to continue current policies even if they fail to meet Obamacare’s minimum standard for essential health benefits; Upton’s legislation, scheduled for a vote Friday, allows insurers to sell existing policies into 2014 to all, even new customers. Udall prefers to let people stay with their current health plan for a full two years, rather than Obama’s one.
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The White House believes Republicans will use any legislation to undermine the law. Late Thursday, the White House issued a veto threat on the Upton bill, calling the proposal “a major step back” in the administration’s efforts to expand affordable health care.
Speaker of the House John Boehner rallied Republicans around Upton’s bill, arguing it advanced their longstanding call for ACA’s repeal. Brad Dayspring, a spokesman for the Senate GOP’s electoral arm, told TPM, “Landrieu is championing legislation to destroy Obamacare.” It’s that sentiment that is driving the administration’s fears against pursuing a legislative fix.
The bills have presented a major political problem for Obama. Landrieu wooed other red-state Democrats up for reelection—Sens. Kay Hagan (D-N.C.) and Mark Pryor (D-Ark.)—but also Sens. Joe Manchin (D-W.V.), Jeff Merkley (D-Ore.) and Dianne Feinstein (D-Calif.). Udall, himself up for re-election, attracted the support of vulnerable Sen. Mark Begich (D-Ala.). On Wednesday, estimates ranged as high as 100 Democrats potentially voting for the Upton bill, but the President’s reaction Thursday lowered the tensions from its boil.
When asked how many Democratic votes Upton’s bill would receive Friday, Rep. Jim Moran (D-Va.), who opposes the plan, said, “A lot fewer than if the President hadn’t spoken today.” One House Republican leadership aide estimated Upton’s bill would attract around 30 Democrats.
“[The President’s] decision is sensible and provides the small number of affected consumers with more information and choices about their health care,” Senate Majority Whip Dick Durbin said in a public statement. “There is no need for a legislative fix for this issue.”
Sen. Chris Murphy (D-Conn.) said that Republicans have “overblown” ACA’s impact on cancellations, adding that he preferred an administration fix to a legislative one.
But the President is still struggling, as even those that support him take a wait-and-see approach. After a Democratic caucus meeting Thursday night, House Minority Whip Steny Hoyer said that the President had taken “positive steps” before adding that House Democratic colleagues may introduce an alternative Friday, allowing members to be on the record for attempting to change the law before the 2014 midterms. Rep. Nick Rahall (D-W.Va.), who is undecided on the Upton plan, recognizes the potential impact of a new slew of Americans for Prosperity anti-Obamacare ads in his district.
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“The fact that they’re bankrolling a campaign against me right now as we speak,” said Rahall, “is going to have negative repercussions.”
The White House is actively cautioning Democrats to hold the line against the Upton bill and allow time to see whether the president’s fix will indeed pan out. Obama’s carefully calibrated response, delivered after a week of intense blowback at the law, doesn’t solve the ‘you can keep it’ promise for all. In fact, it shifts the burden to state regulators and insurance companies to continue to offer plans they have been working to phase out. Already insurance regulators in Washington State have said they will not allow the companies in their jurisdiction to continue the low-quality plans. Insurers, meanwhile, expressed fears about the confusion the last-minute rules change will cause. “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,” said America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni in a statement.
But the White House hopes that Obama’s efforts, and his contrite, nearly hour-long performance before the cameras in the White House briefing room Thursday, will begin to shift public opinion back in favor of the law—or at least stem the bleeding. Earlier this week, Obama earned a record low 39% approval rating in a Quinnipiac University survey, with a majority of those polls believing the president untrustworthy. On Wednesday, the Administration reported that around 106,000 Americans had signed up for the new health care exchanges in October, way below their goal of a half million.
Insurance companies, regulators, and the American people are now struggling to figure out how to cope with the new edict, which could tip the balance for legislative action. Meanwhile, the White House and Democrats on Capitol Hill are closely monitoring the political winds for any sign they’ve stemmed the bleeding. Sen. Angus King, an Independent from Maine who caucuses with the Democrats, says we’ll know “in a matter of days” whether the insurance companies are going to rescind the cancellations. “If they don’t,” he added, “then perhaps we’ll look at something more stringent.”