The head of the National Association of Insurance Commissioners and two members met Wednesday with President Obama to discuss the troubled rollout of the Affordable Care Act.
Kansas Insurance Commissioner Sandy Praeger, a moderate Republican who has generally supported the law, was invited but chose not to attend. NAIC President Jim Donelon, Connecticut’s insurance commissioner, organized the meeting.
Praeger said she wasn’t trying to distance herself from the controversy surrounding the law’s problem-plagued rollout.
But she said the meeting was “premature” because the NAIC had not worked with its members to develop consensus on how to address remaining problems with the law’s implementation.
“It’s a huge honor to be invited to the White House,” Praeger told KHI News Service. “But I want to make sure that we use the president’s time wisely and that we are really able to have some constructive and meaningful dialogue.”
Praeger said the NAIC typically has been a “consensus organization.”
“As a past president of this organization, I think we have a real responsibility to communicate with the leadership and make sure that when we have a meeting that it’s not just representing a single point of view, but it's representing a consensus point of view that’s been arrived at through a vetting process,” she said.
In a joint email sent to their counterparts late Tuesday, Praeger and other commissioners who decided not to attend the meeting said they had “serious reservations about both the process and the policy issues surrounding such an important meeting.”
Adam Hamm, the Republican insurance commissioner from North Dakota, gave similar reasons for skipping the meeting in a statement to the New York Times.
“Because the topic for the meeting (Affordable Care Act) is so delicate and potentially divisive among the nation’s insurance commissioners, a meaningful discussion between all the commissioners needs to take place before a meeting with the president,” said Hamm, who like Praeger is a former president of NAIC. “Unfortunately, that did not happen so I had to respectfully decline to participate in today’s meeting.”
Bob Hanson, a spokesperson for the insurance department, said Praeger also wanted to remain in the state so that she could continue to work with Kansas insurers attempting to comply with President Obama’s recent request that the companies allow customers to temporarily keep policies that don’t meet the ACA’s minimum coverage requirements.
“The Commissioner and her department personnel are in the middle of conferring with companies on how the president's changes might be implemented,” Hanson said in an email. “Those business and regulatory discussions are keeping the commissioner here in Kansas to make sure any details are hammered out in the best interest of our citizens.”
Blue Cross Blue Shield of Kansas, the state’s largest health insurer, announced Tuesday that it would comply with the president’s request and work to reverse approximately 10,000 policy cancellations already in process, allowing policyholders to keep their nonconforming plans another year.
“This governmental change will allow many of our members to keep the benefit plan they already have and like, while still allowing them to consider new plans that they may be able to purchase with the help of a tax subsidy or small business tax credit,” the company said in a news release.
Praeger said reversing the cancellations likely would be costly to BCBS-KS and other insurers and could lead to premium increases. The main reason, she said, was that companies had based their rates on the assumption that many young, healthy people who had nonconforming policies would purchase more comprehensive plans thereby broadening the insurance pool. If significant numbers of those people decide to hang on to their current plans, the mix of policyholders enrolled in more comprehensive plans will be older and less healthy, Praeger said.
“If you’re going to let these healthier folks stay out of the mix for another year, there’s going to be a (cost) impact,” she said.