Reform supporters stress implementation will improve with time

Ahead of President Barack Obama's visit to Boston on Wednesday to highlight the success of Massachusetts' healthcare overhaul, which became the model for the Patient Protection and Affordable Care Act, reform supporters stressed in a conference call with reporters that successful implementation will take time.

Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology who consulted in the drafting of both laws, pointed out that only 123 people signed up for coverage in the first month that Massachusetts' exchange was open for business in 2007. That was less than 1% of the 36,000 individuals who eventually signed up for coverage. Gruber predicted that the federally run and state-run insurance exchanges, which have been plagued by technological problems, will see a similar boost in customers in the coming months.

“What matters is the fact that it will ramp up over time," Gruber said, on a conference call with reporters Tuesday organized by the White House. “That same kind of outcome will happen at the national level, but it will take time.”

Jon Kingsdale, the original executive director of the Massachusetts Health Connector, said there were originally about half a dozen insurers selling products on the state's exchange. That number, however, has since grown to 10 firms.

“It's an extremely competitive market,” Kingsdale said. “I definitely agree this will enhance competition.”

Not surprisingly, the most talked about topic of the day—whether Obama misled the American public when he repeatedly promised that Americans would be able to keep their coverage if they're happy with it—was raised during the call. In recent weeks, people who have individual-market coverage across the country have been receiving notices from their insurers informing them that their current plan won't be available in 2014, in large part because of new rules under the federal healthcare law.

White House senior adviser David Simas stressed that just 5% of consumers are in the individual market that's affected by the changes. In addition, he pointed out that any health plans that were in effect at the time the law was signed in 2010 and haven't been changed were “grandfathered” in and are still permissible.

“I think context is very, very important,” Simas said.

Meanwhile, HHS released a report Monday saying that almost half of young, single uninsured adults in 34 states could pay $50 or less in monthly premiums for exchange coverage after receiving federal premium tax credits. HHS said that out of 7.2 million uninsured Americans ages 18-34 in single-person households in those states, 2.9 million are eligible to buy through the exchanges. And of those 2.9 million people, 1.3 million could pay less than $50 for a bronze-tier plan. About 1.9 million could pay $100 a month or less after receiving the tax credits. Another million could qualify for Medicaid and pay no premiums.

Obama touted those low out-of-pocket costs in an interview Monday. He said those premiums are “less than your cellphone bill, less than your cable bill.”

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