Congressional Republicans broadened their attacks on the Affordable Care Act on Tuesday, saying President Barack Obama misled Americans for years by claiming they could keep the health coverage they had once the new health law kicked in.
In remarks to the American Medical Association in 2009, Obama said: "No matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."
But at Tuesday's House Ways and Means Committee hearing about the troubled Healthcare.gov website, many House Republicans complained that Obama's promise wasn't true. They said their constituents would have to pay more for individual and small group coverage next year because of the health law changes.
Hundreds of thousands of Americans have begun getting cancellation notices from their health insurance companies for 2014 because their policies don't meet the health care law's tough new standards.
Other Republicans cast the situation as yet another failed promise from Obama about the contentious health care law.
"Now we learn that it's only if the White House likes your insurance you can keep your insurance. And if the White House doesn't like your insurance, you can no longer keep your insurance," said Sen. John Barrasso, R-Wyo.
White House Press Secretary Jay Carney tried to quell the growing controversy, saying that the 80 percent of Americans with job-based coverage or government coverage through Medicare, Medicaid or the Veterans Administration would not be affected by the changes.
The health law engineers a complete makeover of the individual and small group insurance markets in 2014. The law guarantees access to coverage regardless of current or past health problems. It also requires each plan to cover at least 60 percent of medical costs and limits annual out-of-pocket costs such as co-payments and deductibles
The new consumer protections also limit the amount that older plan members may be charged; prohibits annual benefit-spending limits; and forbids insurers from varying rates based on gender, occupation or medical claims history.
It's the 5 percent of Americans who purchase coverage in the individual market that will be affected by the changes, Carney noted.
"That's the universe we're talking about, 5 percent of the population," he said, accusing news reports of overstating the effect. "In some of the coverage of this issue in the last several days, you would think that you were talking about 75 percent or 80 percent or 60 percent of the American population."
Dr. Ezekiel Emanuel, a former health care adviser to Obama, said that many of the plans being eliminated were "psuedo plans" or "mini medical plans" that provide spotty coverage that often excludes basic services like child delivery _ which Emanuel called "unethical."
"We should not bemoan the fact that these very poor plans that don't really provide coverage are being eliminated from the health care marketplace," Emanuel said in an interview with MSNBC.
In testimony before the Ways and Means Committee, Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, said half the people with individual coverage "churned," or dropped, their policies in 2010. The individual insurance market is known for high coverage denial rates, along with high customer turnover and dissatisfaction.
For people getting notices that their policies will no longer be available in 2014, Julie Bataille, communications director for the Centers for Medicare and Medicaid Services, said administration officials are confident those folks will be able to enroll in coverage by Dec. 15 if they want coverage in January.
Blue Cross and Blue Shield of Florida CEO Patrick Geraghty told NBC that reports that the company was dropping 300,000 people from coverage were false.
"We're not cutting people," Geraghty said. "We're actually transitioning people. What we've been doing is informing folks that their plan doesn't meet the test of the essential health benefits; therefore, they have a choice of many options that we make available through the exchange. And, in fact, with subsidy, many people will be getting better plans at a lesser cost."
By Tony Pugh and Lesley Clark
McClatchy Washington Bureau