A prominent Democratic healthcare adviser acknowledged late last year troubling problems with Obamacare and predicted more insurers could withdraw from its marketplaces, in an emailed memo to top staff for Hillary Clinton.
Chris Jennings, who has advised President Obama on the Affordable Care Act, wrote that “health insurer and enrollee participation in the exchanges are, at best, disconcerting.”
“No responsible policy analyst would deny that there is a viable scenario where the [Affordable Care Act] could see reduced insurer participation IF the enrollment and financing environment is not improved over time,” Jennings wrote on Nov. 23, 2015, to staffers John Podesta, Ann O’Leary and Jake Sullivan.
“Moreover, it appears clear that the lack of take-up is related to perceptions by many working Americans that the exchange offerings are either too expensive or have too little value, or both,” Jennings continued.
The memo was included in a slew of new emails illegally obtained by WikiLeaks from the account of John Podesta, Clinton’s campaign chairman, and posted online Tuesday.
When Jennings wrote the email, a major insurer, UnitedHealthcare, had just threatened to withdraw from most Obamacare marketplace should its financial situation not improve. United and other insurers have announced since then that they’re pulling out, raising widespread concerns about reduced competition leading to higher premiums.
Democrats have publicly remained optimistic about the law, while acknowledging some of its shortcomings, but Jennings’ email reflects deeper concerns that some advocates for the law talk about only privately.
While Jennings listed some upsides about how the law was performing, including making tax credit subsidies available to people, he had a list of negatives, too. He wrote that enrollment had been “disappointing,” as the Department of Health and Human Services projected 2016 enrollment to be less than half of the 20 million enrollment figure originally projected by the Congressional Budget Office.
He also wrote it’s “painfully clear” that many insurers underpriced their plans with expectations for healthier enrollees, and now that they’re raising premiums, they may scare further new enrollees away.
Jennings urged Clinton, who at the time was seeking the Democratic nomination for president, to emphasize that every law — including the healthcare law — needs to be improved over time and that it’s better than any alternative. He also wrote that Clinton should tweak her approach to talking about the law to “inoculate” herself against any future problems.
The memo, Jennings wrote, “includes suggestions on how Secretary Clinton’s positioning on the ACA — both in terms of rhetoric and policy — should be modestly amended to inoculate her on any possible future problems and as a thoughtful and strong contrast to Senator Sanders and the Republican presidential candidates.”
