President Barack Obama unveiled a package of consumer benefits Tuesday to build support for his health care overhaul within a divided nation and warned Republicans about trying to repeal his landmark law. "We're not going back," said a defiant president.
Obama also sparred with the insurance industry — but this time he sounded a conciliatory note, praising insurers for meeting some requirements of the law ahead of schedule. The legislation "is not meant to punish insurance companies," he said, but will bring them millions of new customers. Still, Obama left no doubt his administration would aggressively confront what he called unreasonable premium hikes.
"There are genuine cost drivers that are not caused by insurance companies," Obama said. "But what is also true is we've got to make sure that this new law is not being used as an excuse to simply drive up costs."
Marking the first 90 days since the bill was signed, the White House rolled out new regulations that explain how several provisions of the law will be carried out, including a ban on insurers denying coverage to children in poor health.
With polls showing Americans split over the health insurance expansion, Obama told an invited audience at the White House that Republicans who seek to reverse such protections do so at their own political peril. "We're not going back," the president emphasized. "I refuse to go back. And so do countless Americans."
The White House called it a "patients' bill of rights," but Republicans dismissed Tuesday's announcement as a public relations effort.
"This shouldn't be called a health care bill of rights, but a bill of goods that the American people aren't buying," said Sen. Orrin Hatch, R-Utah. "There isn't enough slick advertising, politically crafted events or artful sales pitches that will change that."
However, many Republicans agree with at least some of the consumer protections, which were among the least controversial elements of Obama's $1 trillion, 10-year overhaul legislation.
The law's major benefit — expansion of coverage to some 32 million uninsured — doesn't come until 2014. So Obama is doing his best to showcase its modest early benefits.
The safeguards announced Tuesday apply to most health plans renewing on or after Sept. 23. They include:
— Guaranteed coverage for children with pre-existing health problems. The administration estimates that about 540,000 children with health problems are uninsured, and some 51,000 are likely to gain coverage. It's still unclear whether families will be able to afford the premiums. The law does not limit what insurers can charge.
— A ban on lifetime coverage limits. More than 100 million people are enrolled in plans that currently impose such limits, the White House said.
— Phasing out annual coverage limits. Starting this year, plans can set annual limits no lower than $750,000. Such limits rise to $2 million in 2012, and will be completely prohibited in 2014.
— Prohibiting insurers from canceling the policies of people who get sick. Unintentional mistakes on application forms cannot be used to revoke a policy. Most health insurance companies have already complied voluntarily.
— Guaranteed choice of primary care doctors and pediatricians from a plan's network. No referral needed for women to see an OB-GYN specialist. No prior approval needed to seek emergency care out-of-network.
The new rules apply to most health plans, except in cases where they are "grandfathered" under the law.
Starting in 2014, adults with a history of prior medical problems will be guaranteed health insurance as well. In the meantime, the administration is setting up a special high-risk pool starting July 1 to provide affordable coverage to uninsured people with health problems. But a new analysis by the Congressional Budget Office confirms previous estimates that the $5 billion allocated to the program won't be enough to meet needs.
Before his speech, Obama and other senior administration officials met privately with state insurance commissioners, and CEOs of major insurance companies amid concerns over continued premium hikes.
Consumers who buy their policies directly faced increases averaging 20 percent this year, according to a survey released Monday by the Kaiser Family Foundation. Although most Americans are covered on the job, about 14 million purchase insurance on the individual market and have the least bargaining power when it comes to costs.
Health and Human Services Secretary Kathleen Sebelius said the talks with insurance industry representatives at the White House centered on the need to get medical providers and drug companies involved in cost-control discussions.
"We need to be in this together ... the underlying cost drivers are certainly not all isolated with insurance companies," she said. "Having said that, there's no quesition that we're seeing rate increases that so far exceed the cost of medical inflation in some instances that they're difficult to justify."