• Exchange rates
    November 15,2013
     

    One of the serious problems the Affordable Care Act was designed to fix was policies purchased by many individuals with high deductibles and numerous exclusions. Individual policies are usually expensive, but those who buy them may well be glad to have them because they are better than nothing.

    Now they are hearing from their insurance companies that their policies are being cancelled. That’s because the Affordable Care Act seeks to establish standards for insurance, prohibiting policies that gouge customers who have no other options. The problem is that those cancellations fly in the face of the promise that Obama made repeatedly through the 2012 campaign that if you like your policy you will get to keep it. He wasn’t counting on people liking policies that are a bad deal for them.

    Millions of cancellation notices, combined with Obama’s promise, put him in an untenable political position, and Thursday he announced he would allow companies to withdraw their cancellations. He also vowed to press on in his efforts to fix the introduction of Obamacare, even as Republicans in Congress are sharpening their knives with glee in anticipation of slashing the program to ribbons.

    Not so fast. In some places the new health care exchanges are working, or are starting to. States that operate their own exchanges are enjoying better success than the federal government in signing people up. California is doing well, enrolling more than all of the 36 states using the federal exchange combined. The state had enrolled more than 59,000 consumers as of Nov. 9 with 72,000 more who are eligible. For October California had signed up 38 percent of its target number.

    In October Vermont signed up 1,411 for private plans, which was 33 percent of its target.

    As Obama has done, Gov. Peter Shumlin has had to make concessions to the reality of the flawed rollout. He has extended the deadline by three months for individuals and people working for small companies to sign up. These delays, at the state and national levels, represent an admission that things are not going well, but then it would have been hard not to make that admission.

    It is clear that the struggle over health care will continue. Nevertheless, ending insurance that preys on people’s needs in favor of insurance that provides comprehensive coverage at an affordable price is a worthy goal. That goal has led to the cancellation of policies that don’t meet standards.

    But then there’s nothing unusual about holding companies to standards. The Food and Drug Administration prohibits drug manufacturers from selling bogus medicines or to misrepresent what they are selling. Insurance companies should provide insurance that does something besides line the companies’ pockets. If some consumers are willing to be ripped off, others deserve to have protections that will ensure that the coverage they receive is adequate.

    The Shumlin administration, like the Obama administration, has a credibility challenge as it tries to maintain public confidence in Vermont Health Connect, which is the name of Vermont’s exchange. That’s why it was disconcerting to read the story in Seven Days about the job offer made by Anya Rader Wallack to Olivia Shumlin, the governor’s daughter.

    Wallack is the health care expert who resigned as chairwoman of the Green Mountain Care Board to become a private consultant who quickly won a no-bid $100,000 contract to administer a $45 million federal grant. Her knowledge and ability are unquestioned, and it’s good that she continues to be involved in the state’s reforms.

    But offering a job, as she did, to Olivia Shumlin was a lapse in judgment. The no-bid contract was one thing. But offering a job to a recent college grad who happens to be the governor’s daughter should have rung alarm bells. Vermonters don’t want things to get too cozy among state officials handling millions of federal dollars. Olivia Shumlin had the good judgment to turn down the job.

    Government officials must remain squeaky-clean, and they must focus with clarity and determination on the system they are trying to salvage after the premature introduction of the health care website. People’s health and their lives are at stake.

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