Obamacare by any other name....?

Insurers could take heat off GOP to 'replace'

Three of the big health insurance companies are about to give everyone some popular parts of "Obamacare."

And even Republicans who hate the president’s health care plan couldn’t be happier.

On Monday morning, UnitedHealthcare said it would voluntarily give its customers some of the most popular protections in the law — like coverage for young adults — no matter what the Supreme Court says when it rules on the law later this month. Within hours, Aetna and Humana said they were on board, too.

Those announcements could help the insurers head off a major backlash if the Supreme Court strikes down the law. They don’t solve the biggest challenges of health care: how to restrain costs and cover people with pre-existing conditions who are already running up big health bills.

But they’re giving the major insurers a chance to generate some good publicity while getting ahead of the political curve. And for Republicans the big hope is that the insurers’ moves will ease the pressure on Congress to step in if the law is struck down to preserve some of its most-popular features.

House Republican leaders had quietly hatched a plan to preserve some aspects of the law — including the provision allowing adult children to stay on their parents’ insurance — but faced withering criticism from conservatives, who say it’s not the government’s place to decide. The moves by the insurers could take the onus off Republicans to step in with a legislative fix.

“Today’s announcement is a reminder that sensible health care reform does not require the massive government takeover in Washington Democrats’ law, which is hurting our economy by driving up costs and making it harder for small businesses to hire,” said Michael Steel, a spokesman for House Speaker John Boehner. Steel added that the private insurers’ action “reinforces our commitment” to repeal any portion of the law that the court leaves standing.

Rep. Jo Ann Emerson (R-Mo.) offered a similar view. “There is plenty of room for solutions in the private market, and a primary objection to the ACA remains the heavy-handed, bureaucratic approach, which necessarily compels millions of employers and beneficiaries to leave private insurance in favor of a public option,’” she said in an email.
White House spokesman Jay Carney declined to comment on the announcements at a briefing Monday.

Not all of the biggest insurers are on board yet. The Blue Cross Blue Shield Association said only that it is “encouraging its 38 local Blue Cross and Blue Shield Companies to offer their customers the broadest set of protections possible at an affordable price.” And WellPoint said it wouldn’t make any decisions before the ruling.

Still, the announcements show that the health insurers know there are parts of "Obamacare" that the public likes — and that the public won’t appreciate it if the Supreme Court takes them away.

Taking some competitors by surprise, UnitedHealthcare was first out with the announcement that it would keep several provisions: covering young adults until age 26 on a parent’s plan, no co-pays for certain preventive care, stronger appeals, no lifetime limits and no retroactive cancellation of health coverage except in the case of fraud.

Within hours, Aetna announced a similar policy — as did Humana, which said in a statement that it “believes its health plan members should have the peace of mind of knowing the company embraces and will maintain these common-sense provisions that add stability and security to health care coverage.”

Basically, the three insurers agreed to keep most of the early provisions of the health care law that went into effect in September 2010 — and that have been a part of their customers’ health coverage ever since. They have not, however, offered to keep covering children with pre-existing conditions — the other provision that took effect at that time, and one that exposes them to higher costs.

Industry sources predicted the other major players in the insurance industry would follow suit, before or shortly after the high court ruling later this month.

“It’s a very good example of plans stepping up and giving their beneficiaries confidence that they’re going to have continued coverage and opportunities and options,” Karen Ignagni, president and CEO of American’s Health Insurance Plans, told POLITICO on Monday. “And I think you’ll see other plans talking about what they’re going to do as well.”
Ignagni said insurers haven’t been talking too much in public about post-ruling scenarios, but have been thinking about “what is the concern that might exist” if the law is overturned.

Insurance industry analysts and health policy experts said it’s smart business, smart policy and smart marketing for the insurers.

“These provisions are relatively cheap and very popular, and any insurance company preserving them looks like a leader,” said Drew Altman, president and CEO of the Kaiser Family Foundation. “This is a case where the ACA has led the horse to water and it drank.”

A K Street health care lawyer who has worked closely with insurers says it’s an easy call: “The insurers and health plans will keep these provisions in place. It would be a public relations disaster, and impractical in the middle of a plan year to drop them.”

But the move to cover young adults does not solve the toughest coverage challenges: how to provide affordable coverage to older and sicker people, including those with pre-existing health conditions such as cancer or heart disease.

“On a scale of one to 10, these [young adults] are a three — and pre-existing conditions are a 12,” said Robert Laszewski, a health care industry consultant.

Covering young people — a low-risk population that health insurers want to have in their risk pool — may buy politicians time, but it won’t prolong the inevitable need to come up with bigger solutions, Laszewski said.

Ignani agreed that covering mostly healthy young people isn’t the same as covering costly sick people.

“We’ve said for a long time … that to do guaranteed issue, you have to have everyone participating in the pool,” Ignagni said. “If we were in this scenario, we’re going to be working very hard with both sides of the political aisle to answer the question of how to do that.”