The first breach of the Obamacare fortress?

There have been other changes already made in the Affordable Care Act , a.k.a. Obamacare, such as delaying the employer mandate for a year and freeing religious organizations from providing birth control coverage to employees. Obamacare opponents, however, got little traction on those retrenchments.

But President Obama’s declaration yesterday that those who have substandard insurance plans can keep them for another year is going to have a ripple effect on the basic foundation of health care reform and could be the first breach in the wall of solidarity among supporters. Even the debacle that was the launch of the healthcare.gov website will not galvanize the opposition like this about-face. This has “I told you so” written all over it, and the president’s contrite delivery and acknowledgment that he bollixed it will fuel the fire for the entire coming election cycle.

A basic tenet of the health care reform law was not only to ensure all Americans had access to health care but to make sure the plans provided meaningful, comprehensive coverage. In the 2006 Massachusetts law, the mother of Obamacare, it’s called minimum creditable coverage. It’s a requirement that health plans meet a baseline standard of coverage for things such as well-baby visits, preventive and immunization visits with no copay or deductible, and a cap on out-of-pocket expenses. The federal health reform adopted some of the same mandates as well as eliminating the lifetime cap on coverage and barring health insurers from denying coverage to those with pre-existing conditions. Insurance companies went along with it because they could afford the coverage as long as everybody – young, old, healthy, infirmed – was in the same pool.

But the president didn’t do himself or his supporters any favors by declaring that people can keep the coverage they have if they like it. What he didn’t add was they could keep it as long as the plans included the new minimal mandatory coverage. People, especially the young and healthy, bought bare-bones plans that provided catastrophic insurance with none of the required coverage on it thinking they could bypass the expense of the penalty for the individual mandate. But as the January 1, 2014, deadline for the mandate got closer, insurance companies sent notices to those people canceling their plans because they don’t meet guidelines. So much for that presidential promise.

Some are questioning, and rightfully so, why Obama chose to exclude that codicil from his sales pitch. Was it an oversight? Did he think most people would understand? Or did he hope no one would notice? It is now a hard sell for the president to convince people they’ll be better off with plans that meet the ACA minimum requirements. And extending it for a year will make it even tougher to get people to buy in.

In addition, insurers are livid that they were not included in the decision-making. Many are saying this will roil the entire market because rates were based on everyone buying plans or paying the penalties.They worry that premiums will have to rocket up to cover the loss of individuals going back to bare-bones plans. On top of that, most of the insurers didn’t bother asking state regulators for rates for those particular plans because they thought they were being phased out so now they don’t know what they can charge. Some may continue to send out the cancellation notices because the policy change is not law.

On top of all that, some of the states that have well-functioning exchanges, such as California and Washington state, say they will not abide by the president’s announced extension and will force their residents to buy insurance with the minimal coverage. That presents another problem for Obama and Democrats: it’s up to the states whether or not they’ll grant the extension.

Individuals, states, insurers, supporters, Democrats – it’s hard to find anyone who’s not angry with Obama or the fallout. About the only ones who are happy are Republicans. The Globe’s Scot Lehigh says Obama needs to come clean with the country and make his case in a way that’s more presidential than cheerleader.

About the most stinging observation of the change came from the New York Times , which compared Obama’s handling of health care reform to former President George W. Bush ’s performance with Hurricane Katrina and the Iraq War . Ouch, that’ll leave a mark. Hope he’s got a plan to cover that.

–JACK SULLIVAN

      

BEACON HILL

Senate President Therese Murray’s push for an $11-an-hour minimum wage, the highest in the country, draws fire from business leaders, the State House News reports .

Gov. Deval Patrick signs a nearly $74 million housing bond bill . Lawrence will receive $10 million under the legislation, the Eagle-Tribune reports.

MUNICIPAL MATTERS

Boston Mayor Thomas Menino responds to comments made by comedian and TV host Bill Maher about the Marathon bombings, NECN reports .

Boston’s redevelopment arm approves a slate of projects for Menino’s future employer, Boston University . The Herald questions Boston’s habit of handing out anti-blight tax breaks to valuable downtown properties. An Everett businessman sues the city for failing to put Yawkey Way out to bid publicly.

Struggling Central Falls , Rhode Island, is looking for a comeback under young, new city leadership that is employing some out-of-the-box approaches to urban uplift.

CASINOS

With Tuesday’s vote on a Foxwoods casino in Milford fast approaching, campaign finance records indicate the casino is outspending opponents by a margin of 50-1, the Telegram & Gazette reports . The Foxwoods casino team says it’s close to announcing the identity of the project’s majority owner, but the state gaming commission won’t have time to vet that owner before Tuesday’s referendum.

Casino opponents are readying an all-out blitz this weekend to gather enough signatures by next Wednesday’s deadline to place a question repealing the casino law on the 2014 state ballot.

Lynn Mayor Judith Flanagan Kennedy schedules a meeting with Revere Mayor Daniel Rizzo and Suffolk Downs executives on their efforts to locate a proposed casino entirely in Revere, the Item reports . East Boston casino opponents argue that Suffolk Downs could only operate a Revere-only casino legally if it closed down its horse racing track.

The New Bedford City Council voted to take a road trip to Bethlehem, Pennsylvania, to check out that former steel city’s revitalization with a major casino built by KG Urban , the developer that is looking to build a casino in the Whaling City.

Penn National , the would-be operator of a slots parlor in Plainville , has trouble placating neighbors in Foxboro .

NATIONAL POLITICS/WASHINGTON

President Obama’s choice for surgeon general is a doctor at Brigham and Women’s Hospital who is also an instructor at Harvard Medical School.

A CIA database of international money transfers includes the personal information of millions of Americans, including bank account and Social Security numbers.

ELECTIONS

A campaign finance disclosure filed in Colorado pegs a Koch brothers super PAC’s 2012 campaign spending at $122 million. The Kochs’ liberal counterpart, George Soros , gives $2.5 million to upgrade Democrats’ data systems ahead of the 2014 midterms.

BUSINESS/ECONOMY

The developer of Southfield , the mixed use project at the former South Weymouth Naval Air Station, issued a report that says Weymouth could reap more than $1 million next year and more in subsequent years if a proposed change to the governance legislation goes through. Meanwhile, the quasi-public agency overseeing the development got some positive reviews for its performance following a scathing state audit.

Cobb County in Georgia agrees to pay $300 million to help the Atlanta Braves move to a new stadium, Governing reports. Even though the county forced school department employees to take furloughs last year due to budget shortfalls.

EDUCATION

State officials hold a public hearing in Fitchburg on a proposal for a second charter school there. Many municipal officials, including Mayor Lisa Wong and most school officials, say a charter would just sap resources from the improving school system, the Telegram & Gazette reports .

Lesson learned: In the wake of the Dobelle fiasco, Westfield State University trustees approve a measure designed to reduce the number of employees who have university-issued credit cards.

Shirley Leung offers a shout-out to Peter and Carolyn Lynch , whose foundation has poured more than $100 million into various education causes in Boston.

HEALTH CARE

Web glitches snarl health enrollment in Massachusetts, WBUR reports.

TRANSPORTATION

A study by the Army Corps of Engineers says hundreds of buildings in Easton and Stoughton would be affected by increased noise from the South Coast Rail .

Transportation is now almost as expensive as housing in Minnesota’s Twin Cities , Governing reports.

ENERGY/ENVIRONMENT

Cape Wind deadline is looming, and it appears the offshore wind farm won’t make it, CommonWealth reports. Meanwhile, Falmouth tries to figure out how many hours per day to run its wind turbines .

A Peabody plant is sifting through stone and ash at a former city landfill searching for valuable metals, the Salem News reports .

The Tennessee Valley Authority will close eight coal power plants, and cut its coal-fired electricity production by half.

Meet the Author

Jack Sullivan

Senior Investigative Reporter, CommonWealth

About Jack Sullivan

Jack Sullivan is a veteran of the Boston newspaper scene for nearly three decades. Prior to joining CommonWealth, he was editorial page editor of The Patriot Ledger in Quincy, a part of the GateHouse Media chain. Prior to that he was news editor at another GateHouse paper, The Enterprise of Brockton, and also was city edition editor at the Ledger. Jack was an investigative and enterprise reporter and executive city editor at the Boston Herald and a reporter at The Boston Globe.

He has reported stories such as the federal investigation into the Teamsters, the workings of the Yawkey Trust and sale of the Red Sox, organized crime, the church sex abuse scandal and the September 11 terrorist attacks. He has covered the State House, state and local politics, K-16 education, courts, crime, and general assignment.

Jack received the New England Press Association award for investigative reporting for a series on unused properties owned by the Catholic Archdiocese of Boston, and shared the association's award for business for his reporting on the sale of the Boston Red Sox. As the Ledger editorial page editor, he won second place in 2007 for editorial writing from the Inland Press Association, the nation's oldest national journalism association of nearly 900 newspapers as members.

At CommonWealth, Jack and editor Bruce Mohl won first place for In-Depth Reporting from the Association of Capitol Reporters and Editors for a look at special education funding in Massachusetts. The same organization also awarded first place to a unique collaboration between WFXT-TV (FOX25) and CommonWealth for a series of stories on the Boston Redevelopment Authority and city employees getting affordable housing units, written by Jack and Bruce.

A Boston native, Jack has lived in Massachusetts all his life. He was a major in English and history with a minor in political science at the University of Massachusetts, Boston. A father and grandfather, he lives in Plymouth with his wife, Susan.

About Jack Sullivan

Jack Sullivan is a veteran of the Boston newspaper scene for nearly three decades. Prior to joining CommonWealth, he was editorial page editor of The Patriot Ledger in Quincy, a part of the GateHouse Media chain. Prior to that he was news editor at another GateHouse paper, The Enterprise of Brockton, and also was city edition editor at the Ledger. Jack was an investigative and enterprise reporter and executive city editor at the Boston Herald and a reporter at The Boston Globe.

He has reported stories such as the federal investigation into the Teamsters, the workings of the Yawkey Trust and sale of the Red Sox, organized crime, the church sex abuse scandal and the September 11 terrorist attacks. He has covered the State House, state and local politics, K-16 education, courts, crime, and general assignment.

Jack received the New England Press Association award for investigative reporting for a series on unused properties owned by the Catholic Archdiocese of Boston, and shared the association's award for business for his reporting on the sale of the Boston Red Sox. As the Ledger editorial page editor, he won second place in 2007 for editorial writing from the Inland Press Association, the nation's oldest national journalism association of nearly 900 newspapers as members.

At CommonWealth, Jack and editor Bruce Mohl won first place for In-Depth Reporting from the Association of Capitol Reporters and Editors for a look at special education funding in Massachusetts. The same organization also awarded first place to a unique collaboration between WFXT-TV (FOX25) and CommonWealth for a series of stories on the Boston Redevelopment Authority and city employees getting affordable housing units, written by Jack and Bruce.

A Boston native, Jack has lived in Massachusetts all his life. He was a major in English and history with a minor in political science at the University of Massachusetts, Boston. A father and grandfather, he lives in Plymouth with his wife, Susan.

CRIMINAL JUSTICE

Whitey Bulger shuffles off for life. Kevin Cullen says he now heads for “the trash heap of history.” Howie Carr writes about the last bit of unsolved Bulger business: finding the gangster’s money.