WASHINGTON - Republicans and the White House are feuding over whether President Obama's repeated vows over the past four years that insured Americans would be able to keep their current coverage if they wanted to under his health care overhaul were misleading.
Dating back to 2009, Obama regularly suggested during his public pitches of the Affordable Care Act that those who have insurance shouldn't be worried about losing it.
"Under our proposals, if you like your doctor, you keep your doctor. If you like your current insurance, you keep that insurance," Obama said in a 2009 radio address. "Period. End of story."
As recently as an April news conference, Obama underscored that the effects of the Affordable Care Act was already underway for the approximately 85% of insured Americans."And their only impact is that their insurance is stronger, better, more secure than it was before. Full stop," Obama said. "That's it. They don't have to worry about anything else."
However, administration officials said Tuesday that it should be no surprise that a slice of the 5% of U.S. consumers who are on the individual insurance market would be forced to switch plans as a result of insurance providers dealing with meeting the minimum benefit requirement established under the law.
While Obama repeatedly trumpeted the ability of Americans to keep their insurance if they already had it, less emphasized was the reality that some insurers providing bare-bones coverage prior to the full implementation of the law would likely phase out such policies.
Most significantly, the Affordable Care Act established a minimum bar requiring that insurers, among other things, offer preventive care without co-payments, provide maternity care and not refuse applicants with pre-existing conditions.
The law "grandfathered" insurance plans that existed in March 2010 prior to the Affordable Care Act becoming law, allowing those insurers to keep selling coverage even if their less-robust plans didn't meet the health law's requirements as long as the policy was not significantly changed.
But in an ever-changing market - particularly the individual insurance market, where turnover is historically high - changes in policy were expected. The Department of Health and Human Services said as much in June 2010, when it released guidance projecting as many as 67% of individual market policies would lose grandfathered status by the following year.
"Half of the people in the individual market prior to 2010 didn't stay on their policies," Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, told lawmakers Tuesday. "They were either kicked off for pre-existing conditions, they saw their premiums go up at least 20% a year, and there were no protections for them. And sometimes they were in plans that they thought were fine until they actually needed hospitalization, and they found out it didn't cover hospitalization or it didn't cover cancer."
Republicans, however, have seized on the fact that insurers in various markets are dropping plans that don't meet the Affordable Care Act mandate and telling consumers they have to pick new ones as evidence that Obama was knowingly misleading Americans.
During the past few weeks, insurance providers in several states have informed hundreds of thousands of consumers that they will be canceling their insurance plans and will have to pick new ones.
In Florida, 300,000 consumers are receiving notice that the provider Florida Blue will not meet new benefit requirements and that they will be offered alternative policies, said Mark Wright, a spokesman for Florida Blue. Blue Shield of California recently sent out 119,000 similar notices.
And UnitedHealthcare is dropping an undisclosed number of doctors from its Medicare Advantage provider network in Ohio, in what the Ohio State Medical Association is calling "the most significant narrowing of a provider network that we've seen in recent years."
"This is really, really troubling, I believe, for all the American people," said House Majority Leader Eric Cantor. "If the president knew these letters were coming and still indicated that you could keep your health care plan if you liked it, now that raises some serious questions about the sales job of Obamacare."
The decision by Republican leaders to home in on Obama's previous comments Tuesday suggested a shift in the focus of the health care fight from pillorying the administration over the troubled introduction of the health care exchange website to renewing a broader attack on the Affordable Care Act.
"You know, the problem with Obamacare isn't just the website; it's the whole law," said House Speaker John Boehner, R-Ohio. "And I've heard from hundreds of my constituents who are seeing their premiums rise. They're seeing their policies being canceled."
House Minority Whip Steny Hoyer, D-Md., defended Obama but sounded as if he wished the president offered more caveats in touting the law.
"I don't think the message was wrong. I think the message was accurate," Hoyer said. He added, however, "It was not precise enough."