Under the Microscope: President's Coverage Promise Is No Keeper

By David S. Hilzenrath
Washington Post Staff Writer
Monday, August 17, 2009

The debate over health care has become an all-out battle, as the administration, lawmakers and a panoply of interest groups vie to promote their own agendas. In coming weeks, we'll be putting some of their competing claims to the test Under the Microscope.

President Obama promises that, if health-care reform is enacted, people will be able to keep their current coverage.

"I keep on saying this but somehow folks aren't listening: If you like your health-care plan, you keep your health-care plan. Nobody is going to force you to leave your health-care plan," he said Saturday in a town hall meeting in Grand Junction, Colo., much as he said Friday in Belgrade, Mont., and earlier in the week in Portsmouth, N.H.

However, under legislation drafted by House and Senate Democrats, that would not necessarily be true.

Legislation written by three House committees and the Senate Committee on Health, Education, Labor, and Pensions would allow eligible employers to move workers into a new marketplace for insurance, where they could choose from various coverage options.

In the marketplace, called an exchange or gateway, employees could end up with more and better options, analysts say. Even a top Republican staffer to the Senate committee, who is not authorized to speak for the record, agrees with that assessment. But Democratic legislative aides said there is no assurance that any of the options offered in the exchange would be the same as employees' current coverage.

Because coverage offered through an exchange would have to comply with new requirements, it could easily be different.

At a minimum, the exchanges would be open to small employers, but government officials would have the discretion to open the exchanges to larger employers.

"Over time, the Exchange will be opened to additional employers as another choice for covering their employees," the three House committees said in a July summary of the emerging legislation.

The legislation could also prompt some employers to drop coverage, congressional budget analysts say.

In a report last month on a bill advanced by House Democrats, the Congressional Budget Office said millions of people would gain employment-based coverage and millions would lose it. The CBO estimated that the number of people gaining the coverage would exceed the number of people losing it.

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