Reform Update: Obama says reform is working

President Barack Obama on Friday insisted the health reform law is working as it should and praised lower-than-expected insurance premiums in California as he touted a public-private partnership there to help Americans enroll in coverage later this year.

Speaking at the Fairmont San Jose, the president promoted a partnership among Covered California (the state's health insurance exchange), the California Endowment, and three Spanish-speaking media outlets—Impremedia, Telemundo Station Group and Univision—that joined efforts this year to educate Californians about the law and help them get access to coverage when open enrollment begins Oct. 1. The California Endowment will pour $25 million over two years into the partnership, according to a spokeswoman.

It's not surprising that the president promoted the law in California, which has the nation's largest insurance market and is home to about 6 million uninsured Americans. And there's another reason: The White House views young, healthy individuals as a key target audience for the exchanges, and the administration estimates that nearly one-third of young, healthy Americans live in three states: California, Florida and Texas.

“The 13 insurance companies that were chosen by Covered California have unveiled premiums that were lower than anybody expected,” the president said, adding that about 2.6 million Californians—nearly half of whom are Latinos—will qualify for tax credits that will, in some cases, lower their premiums significantly.

But while better-than-expected premiums in California are good news, that's not even half the battle, says John Barkett, director of health policy affairs at Extend Health, a part of Towers Watson. Barkett, a former Democratic staffer on the House Ways and Means Health Subcommittee during the drafting of the health reform overhaul, said he thinks the administration should “throw the kitchen sink” at enrollment efforts.

“It's like saying gas prices are going to be low for the upcoming summer,” Barkett said of the president highlighting the premium rates in California. “But people still need to know where to go for the best vacation.”

That's why Barkett said a whole host of players are needed to help people not simply choose a health plan but also fill out forms correctly to learn how much they're eligible for in terms of subsidies. Barkett acknowledged how difficult it is to help people find a plan that meets their specific needs, which is why he left the Hill for his current role. As he said, the law is transforming Americans into health insurance consumers and it will take plenty of troops on the ground—not just favorable premiums rates—for the law to work well.

“You need all of this human support walking people through the process,” Barkett said. “If you can make the market not only affordable, but navigable, that is the secret to enrollment.”

Prompted in part by a House Republican effort to shift money from the health reform law's Prevention and Public Health Fund into the law's Pre-Existing Condition Insurance Plan (PCIP), The Trust for America's Health this week released The Truth about the Prevention Fund (PDF), a report that provides an overview of the fund and its effects. With more than $14.5 billion in mandatory appropriations over 10 years, the fund is intended to exist in perpetuity. The report highlights the work of communities that received Community Transformation Grants, one element of the prevention fund. “These are funds that make people healthier and need healthcare less,” said Jeffrey Levi, executive director of the Trust for America's Health.

The CMS this week announced that Medicare beneficiaries will see a redesigned statement of their claims for services and benefits to help them identify potential cases of fraud and abuse. In an announcement, the agency said the Medicare Summary Notices will make it easier for beneficiaries to understand their benefits, file an appeal if a claim is denied, and spot claims for services they never received. According to the CMS, the Obama administration has recovered more than $14.9 billion in healthcare fraud adjustments and settlements in the last four years.

Rep. Tom Price (R-Ga.), a physician, introduced the Empowering Patients First Act, legislation he says would repeal the Affordable Care Act and offer tax incentives for people to buy and maintain health insurance coverage. Among the provisions in Price's bill is a measure that would amend the Public Health Service Act to allow individuals to pool together for health benefits coverage through individual membership associations that include churches, alumni associations, trade associations and civic groups. Price's bill would also include medical liability reforms. Price introduced a similar bill offering a conservative version of health reform in 2009.

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