Obamacare: President fine-tunes ‘you can keep it’ promise about insurance

President Obama defended his health-care law Wednesday in Boston while also recalibrating unequivocal statements from the past. Although his speech was a public-relations effort, it could have broader implications for the effectiveness of Obamacare.

President Obama on Wednesday stood up to critics and fact-checkers who say he misled the public with his pledge that if Americans like their health insurance, they “can keep it.”

His approach was a blend of walk-back – recalibrating his unequivocal statements from the past – and pushback against pundits and Republican foes. The backdrop was Boston’s historic Faneuil Hall, with Mr. Obama arguing that Massachusetts has already set up a successful model for Obamacare.

First, he acknowledged what’s been in the news: not only that HealthCare.gov has been malfunctioning, but also that many Americans are getting letters of insurance cancellation, despite presidential pledges that if they like their coverage, they can hang onto it.

“For the vast majority of people who have health insurance that works, you can keep it,” Obama said, referring to those who have employer-based coverage. “For the fewer than 5 percent of Americans who buy insurance on your own, you will be getting a better deal.”

The important thing here: Obama is no longer saying simply that anyone who likes his or her policy can keep it. Instead, he’s saying that those who face changes under the Affordable Care Act (ACA) will be getting “a better deal.”

The president appeared to double down on the promise that people with employer-sponsored coverage can keep plans they like. But that could come up for continued debate between Obama and his critics.

He sounded a note of defiance toward the law’s foes.

“Anybody peddling the notion that insurers are canceling people’s [plans] without mentioning that almost all the insurers are encouraging people to join better plans with the same carrier, and stronger benefits and stronger protections,... you’re being grossly misleading, to say the least,” the president said.

Does this one speech calm the storm surrounding policy cancellations, which are estimated to be affecting several million Americans?

No. But by making these statements, the president got into the fray rather than letting opponents score most of the points – as has been occurring in hearings held by Republican-chaired committees in Congress this week.

Obama’s speech was a public-relations effort, but it could have broader implications for the effectiveness of the law. Between the website troubles and the outrage or confusion that many Americans have about canceled policies, the risk for the president is that publicity about the law not working could become a self-fulfilling prophecy.

The law is premised, after all, on the notion that many young and healthy Americans will buy insurance on the new Obamacare exchanges – and that the premiums they pay will help cover the costs that insurers will incur from enrollees with higher medical costs.

Bad publicity could prompt many potential buyers to opt for a tax penalty, the law’s alternative to becoming insured.

To be sure, Republicans aren’t withdrawing their attack.

“It’s beyond disappointing that, despite the evidence, the president continues to mislead the American people about his health care law,” House Speaker John Boehner said in a statement after Obama’s speech. “The president promised that if you like your health care plan, you can keep it. It wasn’t true when he said it years ago, and, as millions of Americans are finding out, it’s not true now.” 

The controversy mainly surrounds the minority of Americans who shop individually for insurance – not for people insured through an employer-based plan or a government program such as Medicare.

The White House has said that, technically, the law allows insurance plans that individuals had in 2009 to be grandfathered in under the law, whether or not their coverage meets ACA conditions.

In practice, though, it’s common for insurance companies to change their policies frequently. Once they change, the policies need to comply with ACA standards of acceptable coverage.

So, as Obama argued, many Americans will now be offered stronger insurance coverage. And in a shift from prior law, a policy can’t be denied or jacked up in price based on an individual’s health.

Those are key reasons he called insurance under Obamacare “a better deal.” Of course, that’s different from a flat repeat of his “you can keep it” pledge.

Obama also said that many shoppers will qualify for subsidies that bring down the cost of purchasing insurance. That’s true, but numerous anecdotes have also been surfacing in recent days of the opposite: people looking at big premium hikes for 2014.