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Thursday, July 18, 2013

Affordable Care Act Continues To Divide Obama, Lawmakers

President Barack Obama stands with families who benefited from the health care law provision that provides consumers with a refund if their insurance company doesn’t spend the majority of premium dollars on medical care as he speaks about health care reform and the Affordable Care Act in the East Room at the White House in Washington, Thursday, July 18, 2013. (Charles Dharapak/AP)

President Barack Obama stands with families who benefited from the health care law provision that provides consumers with a refund if their insurance company doesn’t spend the majority of premium dollars on medical care as he speaks about health care reform and the Affordable Care Act in the East Room at the White House in Washington, Thursday, July 18, 2013. (Charles Dharapak/AP)

A day after House lawmakers voted for delays in implementing health care reform, President Obama today made a push for his Affordable Care Act, claiming that consumers will see rebates averaging around $100 from health insurance companies under the ACA.

House lawmakers voted largely on party lines yesterday to delay when individuals must have health insurance.

They also affirmed an Obama administration decision to delay when larger employers must offer health coverage to their workers.




From NPR and WBUR Boston, I'm Jeremy Hobson.


I'm Robin Young. It's HERE AND NOW. In a moment, a reporter's notebook from NPR's Deborah Amos, her chapters on the war in Syria and the massive refugee crisis across the border in Jordan.

HOBSON: But first today, President Obama is talking up the Affordable Care Act, also known as Obamacare. His latest pitch is that the rebates some consumers will get average about $100.

PRESIDENT BARACK OBAMA: I'll bet if you took a poll, most folks wouldn't know when that check comes in, that this was because of Obamacare that they got this extra money in their pockets. But that's what's happening.

HOBSON: So that's what the president is saying. Meanwhile, House Republicans once again took up the health care law yesterday, this time to pass a bill that would delay the individual mandate part of the law that requires Americans to have health insurance or pay a penalty. Joining us now for more on all this is NPR's senior Washington editor, Ron Elving. Hi, Ron.

RON ELVING, BYLINE: Good to be with you, Jeremy.

HOBSON: Well, so let's first talk about one of the things the president said today, which is that people are already going to be saving money because of this law. Is that really happening?

ELVING: In many instances, yes. Some people are going to have higher benefits, they're going to have greater protections, and some of the states will also see lower premiums. And the president also talked today about how some checks are going out. Americans received checks last year. About 13 million checks went out last year, about an eight and a half million number will go out again this summer, averaging about $100.

This is because insurers are now required to spend at least 80 percent of the premiums that they collect on actual health care for their policy holders, not on overhead or on profit or on marketing. So if they don't do that, then they have to send some of that money back to the policyholders. That's where that money's coming from.

HOBSON: And the administration has also been highlighting reports that some states, including New York and California, could see lower premiums under the new health insurance exchanges. That was a big story yesterday. But other states are going to see higher costs, right?

ELVING: Yes, there'll be premium joy in some states and premium shock in other states.


ELVING: Ohio, for example, is expecting a big increase in their premiums. And this has to do with the way each state had been regulating health insurance previously and how they're required to regulate it now under Obamacare. In states that used the system that allowed insurers to reject some applicants outright because of existing conditions or, let's say, to base the premiums on factors other than age, like gender and some other health factors, in those states premiums for those who have had insurance already are likely to rise.

Now, in states that have used what's called a community rating system, taking everyone who wants to buy insurance and treating everyone the same within an age group, they're likely to see their premiums fall. That's because the individual mandate is going to bring in a lot of younger and healthier people who right now may not be buying health insurance.

HOBSON: And Ron, what is with this PR blitz right now by the White House? You would think that they would be talking about immigration reform, which hasn't passed, rather than health care reform, which has.

ELVING: You know, you could say the administration has really been talking a lot about immigration reform, but now they're pivoting back to place more defense on the health care law. They really lost control of the narrative on that back in 2009 and 2010. The president as a candidate was a pretty good critic of the existing health care system, but this Obamacare, as we call it now, largely a congressional product, the case for that was not made particularly well.

People didn't really understand the pluses and minuses. They got a lot of misinformation, and the White House has been on the defensive ever since.

HOBSON: And these votes in the House to repeal this law, are House Republicans thinking that maybe one of these times the president's just going to sign it?

ELVING: No, I don't think they think he's going to do that, and I don't think they think the Senate's going to pass it either. But they do hope to find ways to hobble or even cripple Obamacare in the implementation phase and to keep it from going forward if they can.

And let's remember too, the Republicans in 2010 and 2012 promised their voters they would repeal Obamacare outright. So it's important for them to be seen trying to do that every chance they get.

HOBSON: And who's winning the narrative battle with the American people? What do we know about the polling on this issue?

ELVING: You know, as the president said today, 85 percent of the people in the country have insurance and they may not notice whether their benefits or their protections are changing one way or the other. And as for the polls, you know, Obamacare has never been very popular in polls, in part again because a lot of liberals don't like it. They would have rather have had a national health insurance plan.

And of course all conservatives hate it. So maybe the individual parts of the bill do OK in polls, but overall people don't know what to think about it, or they've turned against it already.

HOBSON: NPR's senior Washington editor Ron Elving. Ron, thanks as always.

ELVING: Thank you, Jeremy. Transcript provided by NPR, Copyright NPR.

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Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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