Obama Aims to Reshape Health Care Debate

By: - March 1, 2011 12:00 am

Offering a concession on health care to the nation’s governors, President Obama says he supports a bipartisan amendment to the Patient Protection and Affordable Care Act that would allow states to opt out of many requirements of the controversial federal law as early as 2014.

The president’s announcement came during a face-to-face meeting on Monday (Feb 28) with state chief executives at the White House after the annual winter conference of the National Governors Association in Washington. Many Republican governors who attended the conference have sharply criticized Obama over the health care law’s burdens on state governments.

In his meeting with the governors, Obama said he supports allowing states to adopt their own health care programs, as long as they achieve the same goals as the Affordable Care Act. Governors of both parties have asked Obama for more flexibility under the law.

The congressional proposal the president supports — introduced in the Senate by Democrats Ron Wyden of Oregon and Mary Landrieu of Louisiana and Republican Scott Brown of Massachusetts — would allow states to obtain waivers from the law three years earlier than is currently allowed. To qualify for waivers, states must show that their health care plans will provide a similar level of benefits to at least as many people, at similar rates, without costing the federal government more money.

Under the waivers, states would be exempt from implementing the law’s lynchpin: that most individuals and businesses be required to purchase insurance. Instead, states could find other ways to ensure coverage, such as automatically enrolling people in health plans or providing incentives for purchasing insurance. In addition, states would be free to offer a wider variety of benefit plans, allow large companies to purchase coverage plans from a health insurance exchange, and organize their state insurance markets to promote greater competition. States could also create their own single-payer system, in which the government is the only insurer.

Consumer protections in the law, however, would remain in place. These include requirements that insurance companies cover young adults under their parents’ plan until age 26, pay for preventive services, provide insurance for people with pre-existing conditions, and spend at least 80 percent of premium dollars on health care, rather than administrative costs. Rules against lifetime limits on health care expenditures and against dropping coverage when people get sick would remain in place.

While many Republican governors said they wanted more details about the president’s offer, others downplayed the significance of Obama’s concession.

“The change endorsed by President Obama today is a very minor step that does not provide the kind of flexibility Iowa needs,” a spokesman for Governor Terry Branstad said, according to The Quad-City Times .

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Christine Vestal

Christine Vestal covers mental health and drug addiction for Stateline. Previously, she covered health care for McGraw-Hill and the Financial Times.