Agency chief gives apology for balky site

Insurers drop old policies by hundreds of thousands

Photographers surround Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, as she prepares to testify Tuesday on Capitol Hill in Washington before the House Ways and Means Committee hearing on the implementation of the Affordable Care Act.
Photographers surround Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, as she prepares to testify Tuesday on Capitol Hill in Washington before the House Ways and Means Committee hearing on the implementation of the Affordable Care Act.

WASHINGTON - Marilyn Tavenner, the official in charge of President Barack Obama’s health-insurance marketplace, apologized Tuesday to millions of Americans who have been frustrated in trying to buy insurance under the new health-care law.

“I want to apologize to you that the website is not working as well as it should,” Tavenner said in remarks addressed to the public during testimony before the House Ways and Means Committee.

Tavenner, the administrator of the federal Centers for Medicare and Medicaid Services, said “nearly 700,000 applications have been submitted to the federal and state marketplaces” in the past four weeks.

But she repeatedly refused to say how many of those people had actually enrolled in health-insurance plans since the federal and state marketplaces, or exchanges, opened Oct. 1.

“That number will not be available until mid-November,” Tavenner said. “We expect the initial number to be small.”

The chairman of the committee, Rep. Dave Camp, R-Mich., said at least 146,000 Michigan residents had recently received notices that their current insurance policies would be canceled because the coverage did not meet requirements of the new health-care law.

While it’s unclear how many consumers face cancellation of their insurance nationally, some individual carriers have released data.

Florida’s Blue Cross and Blue Shield, for instance, said about 300,000 members are affected while California’s Blue Shield and Oakland-based Kaiser Permanente will withdraw policies for a combined 280,000. Highmark Health Services of Pittsburgh said 40,000 customers will need to find new plans. Care-First BlueCross BlueShield has notified more than 70,000 customers in Maryland, Washington, D.C., and Virginia that their current plans don’t comply with the Patient Protection and Affordable Care Act.

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AP

House Ways and Means Committee member Rep. Bill Pascrell, D-N.J., shouts across the room at Republican lawmakers during a heated debate Tuesday about problems with the implementation of the Affordable Care Act.

In California, the insurance shift affects 2.5 percent of Kaiser Permanente’s members, said Won Ha, a spokesman for the insurer. About 600,000 to 700,000 consumers with individual health plans will be affected, said Peter Lee, the director of Covered California, the state’s health-insurance exchange. Only about one third will receive subsidies to help pay for their new coverage or be eligible for Medi-Cal, the state’s health coverage for the poor, he said.

“In fact,” Camp said, “based on what little information the administration has disclosed, it turns out that more people have received cancellation notices for their health-care plans this month than have enrolled in the exchanges.”

In campaigning for the health-care law, Obama repeatedly pledged that people who liked their coverage could keep it. But the 2010 Affordable Care Act says that health-insurance policies that fail to offer required benefits, such as prescription-drug coverage and free preventive care, can’t be sold after this year even if they’re cheaper.

“I keep playing that over and over in my head: that you can keep your health plan, period,” said Terri Flay, a Manassas, Va.-area woman whose policy is being canceled, referring to Obama’s pledge. “But it isn’t ‘period.’ They put a gun to my head saying that I have to pay more because I need the health-care insurance.”

Tavenner said that existing insurance policies were, in many cases, inferior to the new policies available on the exchanges. In compliance with the health-care law, she said, new policies will provide more benefits and pay a larger share of medical costs than many existing policies.

The health-care law eliminates “substandard policies that don’t provide minimum services,” said Jay Carney, a White House spokesman, in response to the cancellations. The “80-plus percent” of Americans with employer plans or covered by government programs are unaffected, he said.

Other consumers are pleased with the changes. Barbara Wynkoop, 62, of Trexlertown, Pa., said she expects to find a cheaper plan on the exchange, thanks to subsidies and new coverage for her cholesterol medication.

“The chance for me to save money and still have decent coverage, what my basic needs would be, I’m happy about that,” she said.

The effect on individual premiums will vary on the basis of age, benefits and location, Kaiser’s Ha said in an email: “In general, older beneficiaries will tend to see lower rates or modest rate increases relative to their prior coverage,” he wrote. “Younger beneficiaries, particularly those who had very lean benefit plans, may have significant increases.”

Rep. Kevin Brady, R-Texas, asked Tavenner what she would tell people who were losing their current insurance but could not get coverage on the balky federal website.

“My constituents are frightened,” Brady said. “They are being forced out of health-care plans they like. The clock is ticking. The federal website is broken. Their health care isn’t a glitch.”

Rep. John Lewis, D-Ga., pushed back against Republican attacks on the law and on the administration.

“The Affordable Care Act is working,” Lewis said. “It is making health insurance affordable and accessible to hundreds of thousands of citizens who never had it before. Health care is a right and not a privilege.”

While she admitted the failings of the site, Tavenner tried to hold back a bipartisan clamor for a delay in enforcement of the requirement for most Americans to carry health insurance starting next year.

Lawmakers have said it would be unfair to punish Americans for going without insurance if they cannot obtain it on the federal marketplace, which was built by dozens of companies under contract with Tavenner’s agency.

Two of the contractors who worked on the site testified last week before another congressional committee that the Medicare agency had failed to coordinate the work of dozens of contractors and did not begin “end to-end testing” of the system as a whole until two weeks before it opened to the public. The tests, they said, revealed flaws in the software and suggested that the site could not handle large numbers of users trying to log on at the same time.

Tavenner - like her boss, Kathleen Sebelius, the secretary of the Health and Human Services Department, and her deputy, Gary Cohen - repeatedly assured Congress in the past year that the federal marketplace and its website would be ready Oct. 1.

“This tremendous interest, with over 20 million unique visits to date to healthcare.gov, confirms that the American people are looking for quality, affordable health coverage,” said Tavenner, whose agency insures more than 100 million people through Medicare and Medicaid.

The rocky roll out of the new federal insurance program has irked many consumers, caused some to question the competence of federal officials and created a political crisis for Obama.

“Some have had trouble creating accounts and logging in to the site,” Tavenner said. “Others have received confusing error messages, or had to wait for slow page loads or forms that failed to respond in a timely fashion.”

But, she said, “we will address these initial and any ongoing problems, and build a website that fully delivers on the promise of the Affordable Care Act.”

Sebelius was scheduled to appear today before the House Energy and Commerce Committee. Her written remarks to the hearing echoed Tavenner, saying that “the experience on healthcare.gov has been frustrating for many Americans.”

A handful of Republicans in the House and Senate have been calling for Sebelius to step down. Sen. Lamar Alexander of Tennessee, the top Republican on the Health, Education, Labor and Pensions Committee, said she should be asked to resign.

“No private sector chief executive officer would escape accountability after such a poor performance,” Alexander said Tuesday. “To expect the secretary to correct in a few weeks what she’s not been able to do in 3 ½ years is unrealistic.”

Obama last week appointed Jeffrey Zients, his incoming chief economic adviser, to first advise Sebelius’ department on fixing the website before taking his new job. He said the site should be running smoothly by the end of November.

That would mean two months when the consumer website at the heart of the $1.4 trillion U.S. health-care overhaul won’t be fully operating.

Camp said: “Sooner or later the administration needs to admit the law is unworkable. People don’t have access to health plans, they cannot compare coverage options, and the true cost is often under reported or completely hidden.”

As problems with the health-care overhaul persist, a Republican political group said Tuesday that it will spend more than $2 million in advertising in the coming weeks to tie Senate Democrats Kay Hagan of North Carolina and Mary Landrieu of Louisiana to the law ahead of their re-election bids.

Republicans have several candidates competing in the primary races in both states.

Separately, a Republican super political action committee said it plans to spend more than $300,000 on television ads in Kentucky opposing Senate Republican leader Mitch McConnell. The Senate Conservatives Action ad says McConnell has let down Kentucky voters on the law. A group connected to the super PAC has endorsed businessman Matt Bevin in the Republican primary.

Information for this article was contributed by Robert Pear of The New York Times; by Alex Nussbaum, Shannon Pettypiece, Alex Wayne, Mike Dorning, Anna Edney, Romy Varghese, Alison Vekshin,Toluse Olorunnipa, Kathleen Hunter and Mark Niquette of Bloomberg News; and by Ken Thomas of The Associated Press.

Front Section, Pages 1 on 10/30/2013

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