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Obama launches attack on health insurance companies

Americans' attitudes toward health insurance are complex. Broad majorities of insured people say they are satisfied with their coverage, according to Washington Post-ABC News polls. Only one in eight say insurance would improve if the health-care system were changed.

But that relative satisfaction coexists with anxiety. More detailed Kaiser surveys show that two-thirds of insured people say they worry that their insurance or their care will become more expensive -- and nearly half say they have delayed or skipped care because of the cost.

Robert J. Blendon, a Harvard professor who specializes in public opinion on health care, said it may be difficult for the White House to shift Americans' views about reform, with polls showing they have been relatively static since early fall. Still, he said, the administration has reason to focus on insurance rates, because "the president ran saying, 'I am going to lower your costs,' and most people don't believe there is anything in the bill at the moment that would make that happen." In particular, Blendon said, Obama is trying to overcome that perception by proposing a new Health Insurance Rate Authority.

That proposal, however, has encountered skepticism among state insurance commissioners, who regulate the industry. "I do kind of recoil at the word 'authority,' " said Sandy Praeger, chairman of the National Association of Insurance Commissioners' health-care committee and insurance commissioner for Kansas. She said she favors nationwide minimum standards for regulating insurers. But, she said, "I don't know why they need a separate board," adding that she fears that such an authority could lead to federal powers to override state decisions about insurance rates.

Already, 28 states require health insurers to get commissioner approval for rate increases in the small, expensive individual insurance market, and a dozen require companies to file notices of planned increases. Praeger said there is a risk that, if the federal government blocked premium increases that insurers needed to remain solvent, some companies could be unable to pay claims.

Through the increasing din, insurers have been using their own megaphone to try to counteract the White House's messages, saying they are being vilified.

"All health plans are in the same situation in trying to deal with the steadily increasing medical costs in the delivery system, which are not sustainable," an Anthem spokeswoman said last month when the firm agreed to a request by California regulators to postpone its rate increase. Like other insurers, Anthem also said rates are going up for individual insurance because, in the poor economy, healthy people are dropping coverage, leaving a pool of customers who are sicker and more expensive to cover.

A few constituencies are seizing on the administration's heated rhetoric. As many as 5,000 activists, organized by Health Care for America Now, a coalition of labor and other liberal groups, are planning to amass in Washington on Tuesday to stage a "Stop Big Insurance" rally outside a policy forum that America's Health Insurance Plans is sponsoring.

On Monday morning, before she joined Obama on Air Force One for his speech in suburban Philadelphia, Health and Human Services Secretary Kathleen Sebelius wrote to the chief executives of five large insurers she had summoned to the White House last week. Calling the insurance system "broken," her letter urged the companies to post on their Web sites a 10-point explanation of price increases and their impact.

At Arcadia University in Glenside, Pa., on Monday, Obama propelled the message further, citing a recent conference call convened by Goldman Sachs Global Investment Research in which, the president said, an insurance broker said there was so little competition among health insurers that it was worth it for companies to raise premiums, even if they lost customers as a result. He said: We "allow the insurance industry to run wild in the country."

Staff writers Dan Eggen and Michael D. Shear and polling analyst Jennifer Agiesta contributed to this report.

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