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Once again, some ACA provisions are pushed back

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WASHINGTON — Basic health insurance policies may be kept two more years, the White House said this month.

The extension of the deadline for giving up policies that don’t comply with the Affordable Care Act was the latest in a series of changes to the law that critics have said signify its unworkability. The extension also makes the issue less central to this year’s midterm elections.

President Barack Obama in November announced that insurance plans that fell short of the minimum coverage requirements of the ACA could be kept another year, into 2015. This month’s action went further, delaying for 24 more months the law’s goal of ending what administration officials deemed junk policies.

The Department of Health and Human Services said it had worked closely on the change with lawmakers, and credited the input of several Democrats in tight races, including Sens. Mark Udall (Colorado), Mary Landrieu (Louisiana) and Jeanne Shaheen (New Hampshire).

Secretary of Health and Human Services Kathleen Sebelius said Obama was trying to smooth the way to a new system, using the law’s flexibility.

The two-year extension and other rule changes announced by the White House will insulate more health plans from high patient costs, give states more time to choose whether to operate their own health insurance exchanges, and spare some unions from a fee they opposed.

The administration also is considering the possibility that small-business workers in some states might get a choice of plans, potentially eroding a significant element of the law that federal health officials have already delayed once.

Senior administration officials said that revising many rules simultaneously was a way to address early in the year every significant issue surrounding how the law will work in 2015, which would be a contrast to the confusion and abrupt policy shifts that accompanied the launch of exchanges in the fall.

“We have turned the corner on that,” one official told reporters. “We are putting out the policies early. They are clear. People can rely on them.”

The official said that the White House would not extend the March 31 deadline for people to enroll in a plan at HealthCare.gov, the federal insurance marketplace that three dozen states are using. The next open-enrollment period will run from November 15 to February 15.

Republican critics blasted the new rules, especially the reprieve for bare-bones health plans that don’t provide all the ACA-mandated benefits.

“The administration cannot run fast enough away from its broken promises,” Rep. Fred Upton (R., Mich.), chairman of the House Energy and Commerce Committee, said on Twitter.

Senate Republican leader Mitch McConnell of Kentucky said the White House’s action was “not only another reminder of the president’s broken promise that you can keep your plan if you like it, but represents a desperate move to protect vulnerable Democrats in national elections later this year.

“By announcing a new delay in requiring that policies meet minimum coverage standards, the administration avoids a new round of health policy cancellations set to hit shortly before the November elections.”

Under the transition policy announced by Obama in November, insurers could continue noncompliant coverage through September 2015. Plans could also continue charging women more than men for those policies and increase fees based on a person’s health status, in violation of the law.

Now people will be able to renew policies that don’t meet minimum coverage requirements as late as October 1, 2016, so individuals and small businesses can have noncompliant plans well into 2017.

Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, blogged late last month that 4 million people had signed up for health insurance under the Affordable Care Act. The number was well short of the 5.65 million enrollees that the Congressional Budget Office (CBO) last summer had forecast would have signed up for plans by the end of February.

Tavenner did not reveal how many of the 4 million had paid their first month’s premium, which is required for enrollment to be complete. Experts estimated that about one in five people who had registered for plans did not end up paying for them.

The CBO’s estimates were made before the launch of HealthCare.gov, which was all but paralyzed in its first two months of operation by software flaws. Gary Cohen, who headed the online exchange, has announced his resignation.

The CBO initially estimated that 7 million people would get ACA plans by the conclusion of open enrollment at the end of this month. But conceding that the outlook was altered by the website’s technical problems, Vice President Joseph Biden last month said: “We may not get to 7 million, but if we get to 5 or 6 million, that’s a hell of a start.”


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