Obama: ACA ‘Worked,’ But Improvements Are Needed

WASHINGTON (AP) — Seeking a successful health care sign-up period despite troubling new challenges to his namesake law, President Barack Obama wants to make sure people start enrolling on Nov. 1. That's when the window opens for choosing 2017 health plans under the Affordable Care Act.

Obama planned to make that pitch during an appearance Thursday at Miami Dade College in Miami, Florida, and urge young adults to sign up. Obama also planned to tout improvements to the U.S. health care system under the 5-year-old law. But he'll be attempting a difficult sales job.

Premiums are rising by double digits in many parts of the country and some major insurers have pulled out of the program, leaving consumers with fewer choices next year.

Meanwhile, Health and Human Services Secretary Sylvia Burwell said this week that she expected 13.8 million people will sign up for 2017 coverage, a modest increase over the 12.7 million consumers who picked health insurance plans during open enrollment for this year.

White House spokesman Josh Earnest said Obama has laid out ideas for "tweaks" he thinks would improve the law, including allowing for a public option to increase competition. Under the public option scenario, the government would create and run a health insurance agency to compete with other private health insurance companies in the U.S.

But any changes would have to await the new Congress that gets seated in January, Earnest said. "The current Congress is one that's dominated by Republicans who have voted more than 50 times to repeal the law, but have not once in the last six years actually put forward their own alternative proposal," he said.

The administration says taxpayer-provided subsidies that were designed to increase alongside premiums will soften most of the blow to people's wallets from higher premiums. About 85 percent of customers get this kind of financial help. For policyholders who lost their insurers, the government will automatically match them to another carrier's plan.

Still, millions of people buy individual policies outside of the health care law's marketplaces and many of them will be hit with the full premium increases. Congressional budget analysts estimate there are about 9 million people nationwide with individual policies purchased outside the health care law. The administration estimates that about 5 million are eligible to buy coverage under the law, and half of those — about 2.5 million people — have incomes that would qualify them for subsidies if they checked.

The three-month enrollment season that begins Nov. 1 is the final one for Obama, who wants to help it be a success.

One issue with the law is that insurers say most of those who signed up for coverage turned out to be sicker than expected, which is costing companies money. Young adults, who generally are healthier, make up a disproportionate share of the people who are still uninsured. The administration says it will work aggressively to encourage more of them to sign up for coverage to help stabilize the program.

That's where Obama comes in. Officials are counting on a strong sign-up season to validate the president's signature domestic program, and for a victory by Democrat Hillary Clinton in the Nov. 8 presidential election to shut down the Republican campaign for the law's repeal. Clinton has outlined steps she'd take to build enrollment and sweeten subsidies for consumers.

Republican Donald Trump says the law is a "disaster" and would replace it.

Rep. Kevin Brady, R-Texas, the House Ways and Means Committee chairman, said the law is "driving up costs, driving down quality, and driving out choice and competition." He said Obama owes the American the people the facts, "not more rosy rhetoric about how the law is supposedly working."

Obama pushed the Affordable Care Act through Congress in 2010 to help millions of people who were without health care coverage. Most Americans get health insurance through their employers.

Under the law, more than 21 million previously uninsured people are now covered. Consumers are also covered by new protections in the law, including allowing children to stay on their parents' plans through age 26 and not having to pay for preventive care.

After discussing health care, Obama is turning his attention to politics. He plans to speak at a Clinton campaign rally at Florida Memorial University in Miami Gardens. He's also scheduled to address a Democratic governors fundraising dinner that is closed to the news media.

Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.

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