White House in Obamacare Panic Mode? Administration Announces Steps to Maintain Insurance Coverage as Worries About Disruptions Mount

How anxious is the Obama
administration about the health care law’s effects on insurance
coverage? For the last few days, speculation has increased about
the possibility that the law could actually result in a net loss of
coverage at the beginning of next year—with more people losing
existing insurance as a result of cancelations than have signed up
for new insurance plans under the law. An announcement this
afternoon strongly suggests that the administration is more than a
little bit concerned about this possibility as well.

The Department of Health and Human Services said this afternoon
that it will
extend coverage options for individuals currently enrolled in
the law’s temporary high-risk pool program through the end of
January, instead of allowing the program to end on December 31 as
originally planned.  It will also require private insurers
selling policies in the law’s insurance exchanges to accept payment
up until December 31 of this year for coverage than begins January
1. 

In addition, HHS said it would “strongly encourage” insurers to
take other “transitional” steps over the next month as well—steps
like accepting partial pre-payment for coverage that begins on
January 1 as a “down payment” in lieu of full payment prior to the
start of coverage and allowing people who sign up after the
December 23 deadline to begin coverage on January 1. HHS also said
it hoped insurers would accept out of network providers as
in-network for “acute episodes” or in cases in which a provider was
listed in an insurer’s enrollment directory but dropped out after
an individual’s enrollment date.

On an afternoon conference call about the changes, the
administration even suggested that insurers should consider
accepting as enrolled anyone who has signed up for a plan by
December 23—even if the person in question has not paid the first
month’s premium at all. Payments could be made after January 1, and
after coverage kicked in. 

What does it mean to “strongly encourage” insurers to take these
steps? It’s difficult to say for sure. But probably it means that
the administration is worried about what’s coming, and plans to
blame insurers who don’t take the administration’s encouragement
when the bad news arrives.

It’s clear from the announcement that federal officials are
worried, even panicked, about what comes next. Asked on the
conference call whether the administration was confident that more
people will gain coverage than lose it come the beginning of next
year, a spokeswoman for the Centers for Medicare and Medicaid
Services dodged the question—responding that it’s important to
remember that there are still three more months in the open
enrollment period, and that the real goal is to ensure a viable
demographic mix of enrollees on a market by market basis. In other
words, the administration isn’t saying that more people will lose
coverage than gain it comes January 1. But they’re not saying that
won’t happen either.

HHS Secretary began today;s call by calmly asserting that for
millions of people, the “security of health coverage is finally
within reach,” which in the upside-down world of the administration
is as telling a sign as any that it isn’t. The administration is
trying to put a happy face on its desperation, but the lack of
confidence implied by today’s announcement is not what anyone would
call strongly encouraging.