Campaign Promises

Cabinet/Departments -> Health & Human Services -> Health Insurance


ItemHealth & Human Services
Health InsuranceGrade
HE-31
The Promise: "Create a "National Health Insurance Exchange to help Americans and businesses purchase private health insurance."
When/Where: Obama-Biden Plan to Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All, dated 10/03/08.
Source: http://courses.ischool.berkeley.edu/i202/f08/lectures/Obama_Healthcare-1.pdf
Status:On 07/14/09, the House tabled its version of America's Affordable Health Choices Act (AAHCA) of 2009. Title III, Section 301 of the bill presented by the House proposed to create a National Insurance Exchange under a Health Choices Administration, with a Commissioner to run it.

Section 1311 of the Senate version of the health care reform bill stated in part "Each State shall, not later than January 1, 2014, establish an American Health Benefit Exchange."

The final language included in the Patient Protection and Affordable Care Act (Public Law 111-148), signed into law by President Obama on 03/23/10, supports the Senate version of the Health Care Reform effort in that the exchange is to be established at the State level, not the National level.

This promise was not fulfilled.
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HE-32
The Promise: "Require insurance companies to cover pre-existing conditions...at fair and stable premiums."
When/Where: Obama-Biden Plan to Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All, dated 10/03/08.
Source: http://courses.ischool.berkeley.edu/i202/f08/lectures/Obama_Healthcare-1.pdf
Status:Section 2704 of the Patient Protection and Affordable Care Act (Public Law 111-148) signed into law by President Obama on 03/23/10, is entitled "Prohibition of Preexisting Condition Exclusions or Other Discrimination Based on Health Status." This is self-explanatory.

This promise was fulfilled.
1.00
HE-33
The Promise: "If you don't have insurance, or don't like your insurance, you'll be able to choose from the same type of quality private plans as every federal employee...All of these plans will cover essential medical services including prevention, maternity, disease management and mental health care. No one will be turned away because of a pre-existing condition. If you change jobs, this insurance will go with you. And if you can't afford this insurance, you'll receive a tax credit to help pay for it."
When/Where: Obama Campaign Speech, Asheville, NC dated 10/05/08.
Source: http://www.presidency.ucsb.edu/ws/index.php?pid=84480
Status:Section 1312 of the Patient Protection and Affordable Case Act (ACA) of 2010, signed into law on 03/30/10, stipulates that "the only health plans that the Federal Government may make available to Members of Congress and congressional staff...shall be health plans that are created under this Act...or offered through an Exchange established under this Act...".

Promised medical services are included in this Act such as prevention (Title IV), maternity (Section 10213), and disease management and mental health care (both under Section 1302). Health plan tax credits for low-income individuals are addressed in Section 1331(e) of the Act.

As of CY2016, tax credits payable to insurers under the ACA are based on income and available to American taxpayers making between 100% and 400% of the Federal Poverty Level (between $11,770-$47,080 for an individual and between $24,250-$97,000 for a family of four).

On 11/14/11, the Supreme Court agreed to hear the legal challenges to the ACA filed by 26 states and the National Federation of Independent Business. On 06/28/12, the Supreme Court upheld the Patient Protection and ACA of 2010 as constitutional. The majority ruled that the "individual mandate" for most U.S. citizens to obtain insurance or pay a penalty was authorized by Congressional power to levy taxes. The Supreme Court again upheld the ACA on 06/25/15.

This promise was fulfilled.
1.00
HE-34
The Promise: "...will expand the number of options for young adults to get coverage by allowing young people up to age 25 to continue coverage through their parents' plans."
When/Where: Obama-Biden Plan to Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All, dated 10/03/08.
Source: http://courses.ischool.berkeley.edu/i202/f08/lectures/Obama_Healthcare-1.pdf
Status:Under the Patient Protection and Affordable Care Act (Public Law 111-148) signed into law by President Obama on 03/23/10, children will be able to get health insurance coverage under their parents' insurance plans as long as they do not have the possibility of acquiring coverage through their own employers and have not yet turned 26 -- one year longer than originally proposed by then-candidate Obama.

This promise was fulfilled.
1.00
HE-35
The Promise: "I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family's premium by up to $2,500 a year."
When/Where: Obama Campaign Speech, Hartford, CT, dated 06/23/07.
Source: http://www.presidency.ucsb.edu/ws/index.php?pid=76986
Status:President Obama signed the Patient Protection and Affordable Care Act (ACA) of 2010 on 03/23/10.

In CY2009, when President Obama became President, premiums for a "typical" family where the principal earner worked for a small business (3 to 199 employees) was about $12,696. This rose to $17,546 by CY2016. Premiums for workers in large companies (200 or more employees) rose from $13,704 in CY2009 to $18,142 in CY2016.

On 10/03/16, former President Bill Clinton provided his views on ACA, also referred to as "Obamacare:" "So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world."

This promise did not address the cost of premiums after tax credits, etc., simply the cost of premiums. As more insurance providers withdraw from ACA exchange participation such as Aetna, Humana and UnitedHealth Group, premium costs are expected to skyrocket during CY2017 with the national average increase by about 25%. Such increases will vary by state but in Phoenix, AZ alone, individual benchmark insurance premiums in the ACA marketplace are expected to increase by a whopping 145%. In Birmingham, AL, that increase is estimated to be 71% in CY2017.

One of the root problems of this evolving situation is that the number of older, sicker enrollees outpaces the number of younger, healthier people signing up for health insurance, preferring to pay an annual fine over more expensive coverage. Another problem is that instead of the 20M insurance purchasers estimated by the Office of Management and Budget (OMB) by end-CY2016 to make ACA work, only between 11M and 13.8M people have signed up.

This promise was not fulfilled.
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HE-36
The Promise: "Health plans will be required to disclose the percentage of premiums that actually goes to paying for patient care as opposed to administrative costs."
When/Where: Obama-Biden Plan: "To Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All," dated 10/03/08.
Source: http://mendocinohre.org/rhic/200812/HealthCareFullPlan.pdf
Status:Section 2718 of the Patient Protection and Affordable Case Act of 2010, signed into law by President Obama on 03/30/10, stipulates that "A health insurance issuer offering group or individual health insurance coverage shall, with respect to each plan year, submit to the Secretary a report concerning the percentage of total premium revenue that such coverage expends (1) on reimbursement for clinical services provided to enrollees under such coverage; (2) for activities that improve health care quality; and (3) on all other non-claims costs, including an explanation of the nature of such costs, and excluding State taxes and licensing or regulatory fees."

This promise was fulfilled.
1.00
HE-37
The Promise: "In markets where the insurance business is not competitive, their plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration."
When/Where: Obama-Biden Plan: "To Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All," dated 10/03/08.
Source: http://courses.ischool.berkeley.edu/i202/f08/lectures/Obama_Healthcare-1.pdf
Status:Section 2718 of the Patient Protection and Affordable Care Act of 2010, entitled "Bringing Down the Cost of Health Care Coverage," states in part: "a State shall seek to ensure adequate participation by health insurance issuers, competition in the health insurance market in the State, and value for consumers so that premiums are used for clinical services and quality improvements."

Section 2718 also requires insurance providers to rebate part of the premiums it received if 85% of those premiums were not spent on doctor or hospital bills or activities to improve health care quality. For CY2011, for example, the UnitedHealthcare insurance company met only 84% of the established expenditure criteria and had to issue rebates equivalent to 1% of its earned premium dollars to employers or group policyholders by 08/01/12.

This promise was fulfilled.
1.00
HE-38
The Promise: "Under the plan, if you like your current health insurance, nothing changes..."
When/Where: Obama-Biden Plan to Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage For All, dated 10/03/08.
Source: http://courses.ischool.berkeley.edu/i202/f08/lectures/Obama_Healthcare-1.pdf
Status:Commencing in CY2011, $132B in federal subsidies to support Medicare Advantage (MA) plans started to be phased out. With the gradual elimination of these subsidies, coverage for expenditures such as for dental care, hearing aids and eyeglasses were reduced or eliminated. Costs of premiums for these services increased as seniors tried to find similar coverage elsewhere.

So for seniors who liked their health insurance coverage under MA through CY2010, their plan started to change in CY2011. In testimony before Congress on 01/26/11, Medicare Actuary Richard Foster supported this view by stating that he expected 7M MA participants to be forced to purchase supplementary health insurance over time because of the Government's curtailment of support to the MA plans they liked and therefore selected prior to CY2010.

Despite contradictory analyses, it is safe to consider, based on media reports, that between 2.6M and 4.7M health insurance policies were cancelled between CY2010 and CY2014 regardless of whether a policyholder was happy with his/her plan. In most cases, the cancelled plans did not meet the coverage standards mandated by the ACA. Insurers that did not leave the individual health insurance market altogether offered their policyholders alternative plans, often plan the policyholder did not like.

Since the implementation of the Patient Protection and Affordable Care Act (ACA) on 10/01/13, not only have insurance premium rates continued to rise, but millions of health insurance policies that policyholders liked have been cancelled.

It should be noted that there was no guarantee in the ACA that policyholders would get to keep their health insurance policies just because they liked those policies.

This promise was not fulfilled.
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