A Health Primer

From The Wall Street Journal:

Q: What just happened?

A: President Barack Obama, under pressure from both Democrats and Republicans in Congress, said his administration would ask state insurance commissioners to permit insurers to keep selling individual health policies they earlier had canceled because the policies didn't meet standards set by the 2010 Affordable Care Act.

Q: What was wrong with those policies?

A: New federal requirements in the law for plans that take effect in 2014 are often tougher than practices allowed by the states. For example, the plans are supposed to offer free preventive care and can't charge higher rates for women or people with pre-existing illness.

Q: If an insurer revives a canceled plan, how long can a person stay on it?

A: The initial extension applies to annual plans that take effect from Jan. 1, 2014, to Oct. 1, 2014. However, the administration left the door open to a further extension that would apply to plans starting in 2015.

Q: Can't people losing coverage get it through the new health-insurance exchanges?

A: In theory, yes. But the federal HealthCare.gov website has made it hard for many to sign up. And even if they can buy new coverage, some say they would prefer their old insurance because it was cheaper or was accepted by their doctor.

Q: Can Mr. Obama do this on his own?

A: White House officials say the administration has authority to make temporary policy changes, as he did in deferring the removal of immigrants who came to the country without authorization when they were children. Republicans said then the president might be overreaching his authority, and they sounded similar notes Thursday.

Q: Why do state insurance commissioners have to sign off, and will they?

A: States regulate insurance, and state commissioners have final say over whether plans are reinstated. Earlier, some state regulators took a dim view of insurers trying to keep the old plans. Others have signaled more enthusiasm and one, Dave Jones of California, already has pushed insurers in his state to let people keep existing coverage a little longer.

Q: Will insurers agree?

A. Some might jump at the chance. Others are likely to stick to their decisions. "You can't put toothpaste back in the tube" is the gist of the view expressed by some health-policy experts.

Q: So it won't happen?

A: White House officials say not all regulators will agree to the proposal, and not all carriers will reinstate plans for the millions of people who have received cancellation notices. That would underscore the gaps in Mr. Obama's earlier promise that Americans who liked their plans could keep them.

Q: What if it does happen?

A: It could hurt the finances underpinning the law. Many people whose plans are being terminated are considered to be healthy—and were expected to help balance the risk pool in the exchanges. An insurance-industry group says Mr. Obama's changes "could destabilize the market and result in higher premiums for consumers."