(Bloomberg) — As hopeful Republican successors promise to repeal President Barack Obama's massive health care overhaul in their campaigns, his administration is looking for ways to make the Patient Protection and Affordable Care Act (PPACA) exchange system blend in with the rest of the U.S. health system.
Gone are some of the extraordinary measures used to overcome early stumbles and get people signed up for the national program to increase coverage. In their place, the administration is emphasizing stability and efforts to make the controversial program resemble any other insurance marketplace.
"Obamacare is saving lives and it's saving money," Obama said Thursday in Milwaukee in a speech defending his signature program. "People like what we've done, the people who are actually using it."
The fate of PPACA is a major point of contention in the presidential campaign. Republican contenders Donald Trump, Marco Rubio, Ted Cruz and John Kasich insist they will dismantle Obamacare. On the Democratic side Hillary Clinton has supported it, and Bernie Sanders has endorsed a bigger role for government. About 12.7 million people have signed up for individual plans in the law's third year of providing coverage.
The government recently made it harder for individuals to enroll in PPACA plans outside the normal sign-up period, a change that benefits insurers because it reduces the possibility that people will wait to buy plans until they're sick. The federal government also backed off plans to impose tighter standards on insurers' networks of doctors and hospitals, though it will give enrollees an indication of how broad each insurer's network is.
Sustainable market
"These are improvements that you would expect to happen regularly in a mature program," said Larry Levitt, a senior vice president at the Henry J. Kaiser Family Foundation. "The operations have kind of normalized, but there are still lots of political uncertainties swirling in the background."
About 20 million Americans have gained health coverage under PPACA, including Medicaid enrollees and children allowed to stay on their parents' plans, Obama said in the speech. The Centers for Medicare & Medicaid Services (CMS), which oversees the program, is focused on ensuring that the marketplace that will remain sustainable, said Andy Slavitt, the agency's acting administrator. His discussions with insurers suggest that the agency is moving in the right direction, he said.
"A lot of the companies are viewing that they now can put together strategies that help them succeed," he said Monday in an interview.
Most insurers will probably continue to sell health plans through the PPACA exchange system next year, Slavitt said. The government will get a look at insurers' plans in the comings months as they begin submitting 2017 offerings and premium rates.
Balancing act