President Barack Obama made a personal bid Monday to shore up his signature health law as it heads into its final test of his administration, urging insurers selling plans on HealthCare.gov to stay the course and pledging redoubled efforts by the government to make the law a success.
In a letter released publicly by the White House on Monday, Mr. Obama thanked insurers for participating in the health exchanges the federal government runs on behalf of three dozen states, which the Obama administration calls ‘the Marketplace,’ and acknowledged some of its recent turbulence.
“I appreciate your organization’s contributions to that progress and your ongoing commitment to your consumers, your community, and our Nation,” he wrote. “We know that this progress has not been without challenges. Most new enterprises have growing pains and opportunities for improvement. The Marketplace, while strong, is no exception.”
Mr. Obama’s message was aimed at reinforcing the decisions of insurers who have stayed in the government marketplace at a time when some large insurers have pulled back. Relatively lackluster enrollment to date has pushed up HealthCare.gov premiums for the year ahead in many states and prompted large insurers such as UnitedHealth Group andAetna Inc. to scale back on their participation. Some smaller plans, notably the co-ops set up by the law, have folded.
On Monday, New Jersey’s insurance regulator confirmed that the state’s co-op, Health Republic Insurance of New Jersey, would be placed into a rehabilitation process and wouldn’t be allowed to offer coverage for 2017. People who are enrolled in Health Republic policies in the state will remain covered through the end of the year, the regulator’s office said. The failure of the co-op leaves approximately half a dozen of the 23 co-ops created and funded by the law still standing.
The danger for the law’s supporters is that the individual insurance market’s problems compound each other, with price increases further dissuading all but the sickest people from signing up for coverage, and their big medical claims continuing to drive prices higher still.
Mr. Obama’s Health and Human Services secretary, Sylvia Mathews Burwell, has sought to characterize the turbulence facing the law as temporary. She has said she expects better enrollment from healthy people in the new sign-up window opening Nov. 1 because of new efforts to emphasize the penalty people face for going uninsured and stepped-up federal attempts to ensure that people aren’t booted from their coverage because of bureaucratic errors.
The agency has also made some changes to regulations governing people’s ability to sign up outside of the normal enrollment window that had long irked insurers.
The president noted those efforts in his letter, and said he, too, had a “commitment to making sure the Marketplace continues to work long after I leave office.” He concluded: “I look forward to our continued success.”
Mr. Obama also made a brief personal appearance at a meeting at the White House between administration officials and executives representing more than a dozen of the biggest insurance companies or networks.
Chief executives from Humana, Cigna, the Blue Cross Blue Shield Association, and others participated in the White House meeting that also included Ms. Burwell, and Valerie Jarrett, one of the president’s top advisers.
“Administration officials underscored the importance of continuing the work that has helped bring the nation’s uninsured rate to the lowest level on record and solicited ideas for how to further strengthen the Marketplace,” a White House aide said.
In a fresh sign of challenges facing HealthCare.gov, however, the Government Accountability Office said on Monday that undercover testing of the site and its infrastructure showed its verification capacity was still strained. Investigators from the congressional watchdog said they had successfully enrolled 12 out of 15 fictitious applicants in coverage for 2016, with the other three getting bumped at the payment stage. Only one of the applicants who made it through payment was terminated for failing to respond to additional requests for documentation.
Out of the 12 accounts enrolled and for which payments had been processed, four were for fictitious applicants who had previously obtained coverage and were able to get it again despite not having filed 2014 tax returns—a new requirement to retain coverage that was put into effect in the last sign-up window. Federal officials said they had allowed individuals to attest to the fact they had filed tax returns to allow for a time-lag between the filing of returns and their reflection in Internal Revenue Service systems, but were carrying out subsequent checks. Each of the remaining eight were new creations that were able to successfully pass through identity and immigration checks and enroll in coverage.
When additional information was requested for 11 out of 12 fictitious applicants, five provided documents and retained coverage, three provided only partial documentation and retained coverage, and three provided no documents. Only one of those three was terminated then.
Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, said the agency took its responsibility to run the site seriously, and was disappointed the GAO wouldn’t give it “specific and actionable information” about how it managed to circumvent the system to help fix the problems. “Within HealthCare.gov we have multiple checks to verify that applicants provide correct eligibility information on their applications, and GAO deliberately circumvented those checks by giving false information, which is against the law for actual applicants,” Mr. Albright said.