Sebelius spent more than three hours fielding questions about problems with the federal HealthCare.gov website, decisions that HHS and the CMS made before the Oct. 1 launch of open enrollment, privacy and security concerns for consumers, accountability of federal contractors working on the federal system, and Obama's earlier promise that Americans who like their health insurance plans can keep them. But she turned aside questions about how many Americans have actually enrolled so far on the federal exchange. A number of congressional Republicans have called for her ouster.
Obama's speech on the same day showed that he is well aware that the fate of his historic law establishing near-universal health coverage for Americans and a new framework for controlling the country's healthcare spending is in the balance.
After joking that he realized that a presidential visit to Boston takes second place for Bostonians to the Red Sox potentially clinching the World Series title Wednesday night, the president said he was in Faneuil Hall because it was there seven years ago that Republicans and Democrats came together to make healthcare reform a reality for Massachusetts.
The president was quick to point out, as Democratic Gov. Deval Patrick did before him, that the early phase of reform in the Bay State in 2006 was far from easy. Enrollment, Obama noted, was extremely slow at the start, as only about 100 people signed up for insurance in the first month. But by the end of the year, that number grew to about 36,000 enrollees, and today Massachusetts has nearly universal coverage for its residents.
He then ticked off a list of benefits and consumer protections that the Affordable Care Act provides before he acknowledged the problems associated with the federal website.
"There's no denying it. Right now, the website is too slow. Too many people have gotten stuck, and I am not happy about it," the president said. "And neither are a lot of Americans who need healthcare, and they are trying to figure out how they can sign up as quickly as possible," he continued. "So there's no excuse for it, and I take full responsibility for making sure it gets fixed ASAP. We are working overtime to improve it every day."
The president also talked about his promise that those Americans who like their health plans can keep them. He acknowledged that millions of people with existing individual-market health policies have received notices from insurers canceling their coverage.
They have been notified that they will have to sign up for a new plan that complies with the requirements of the ACA, which in many cases means higher premiums, richer benefits and lower out-of-pocket costs. Insurers can continue to offer noncompliant plans that were in effect before the ACA passed and that haven't been significantly changed since then, though they have the option to discontinue those plans as well.
But the president explained that the ACA was designed to help both the uninsured and the underinsured. He said less than 5% of Americans were in "cut-rate” individual-market plans that didn't offer real financial protection in the event of a serious illness or accident and were facing the prospect of having their policy canceled because of the reform law.
"If you had one of these substandard plans before the Affordable Care Act became law and you really liked that plan, you were able to keep it. That's what I said when I was running for office. That was part of the promise we made," Obama said. "But ever since the law was passed, if insurers decided to downgrade or cancel these substandard plans, what we said under the law is you have to replace them with quality, comprehensive coverage because that, too, was a central premise of the Affordable Care Act from the beginning."
Obama also said that critics who cite the plan cancellations but fail to mention that insurers are urging subscribers to join their new plans with fuller coverage, or who fail to mention that new federal tax credits will reduce what many people have to pay for their premiums, are "being grossly misleading, to say the least."
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