A Contrite Obama Unveils a Health Fix

WASHINGTON - President Obama bowed to mounting political pressure from across the country and on Capitol Hill on Thursday and announced new rules that will let insurance companies keep people on health care plans that would not have been allowed under the Affordable Care Act.

Mr. Obama, seeking to address an outcry that has shaken public confidence in the new health law, told reporters at the White House that the changes should allow most people to retain their health care plans for a year despite having received letters saying they could no longer keep their insurance.

“I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked they could keep it,” said Mr. Obama, who repeatedly took personal responsibility for the health care rollout, which has thrown Democrats on the defensive. “And to those Americans, I hear you loud and clear. I said that I would do everything we can to fix this problem. And today I’m offering an idea that will help do it.”

The president’s plan would apply only to people who have had their existing policies canceled. Those currently without insurance would not be able to buy the old plans.

Despite the president’s reversal, Speaker John A. Boehner said that he intended to push ahead with a House vote Friday on a measure that would allow consumers to keep their canceled plans without penalty and allow others to sign up for them. Mr. Boehner said that he was skeptical of the president’s plan, and that the new law needed to be overturned.

“The only way to fully protect the American people is to scrap this law once and for all,” Mr. Boehner told reporters.

Representative Nancy Pelosi, the Democratic leader in the House, said her members were clamoring for a fix on top of what the president was offering. Many of them, she said, were those who fought hard for the law’s passage and want to see it saved. Other Democrats said they wanted a more permanent resolution of the cancellation issue, suggesting that Mr. Obama’s plan would not quiet the clamor.

The president’s announcement also drew a cool reaction from insurers.

“Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers,” said Karen M. Ignagni, the president of America’s Health Insurance Plans, a trade group. “Premiums have already been set for next year based on an assumption about when consumers will be transitioning to the new marketplace. If now fewer younger and healthier people choose to purchase coverage in the exchange, premiums will increase, and there will be fewer choices for consumers.”

A White House official confirmed that “we don’t have a commitment from state insurance commissioners” to go along with the president’s new policy. State insurance regulators also said they had not discussed it with the administration.

In a nearly hourlong news conference, Mr. Obama repeatedly acknowledged that the start of the new health care program had been botched.

“I am very frustrated,” Mr. Obama said in one of his most self-reflective moments since he moved into the Oval Office. “But I’m also somebody who, if I fumble the ball, I’m going to wait for the next play and then run as hard as I can to do right by the team.”

The president said he did not intend to mislead Americans about whether they could keep their health insurance, but again expressed regret that his assurances turned out to be wrong. He attributed that to a poorly designed law.

But he repeatedly said that the myriad problems that his administration faces is “on me.” He said he would have to work harder in the days and months ahead to win back his credibility with the American people.

Mr. Obama, who will not face the voters again, offered apologies to Democratic members of Congress who will be on the ballot and are furious about having to defend a health care law that has become so unpopular with Americans in the wake of the bungled rollout. The health law flaws have given Republicans a chance to shift the focus to Democrats just weeks after Republicans got most of the public blame for the government shutdown.

Mr. Obama said he felt “deeply responsible for making it harder for them, rather than easier for them, to continue to promote the core values that I think led them to support it in the first place.”

He said critics were “properly focused” on the problems with the implementation of the health care law, and said that the current criticism was more valid than attacks on his actions in the past.

“There were times I thought we got slapped around unjustly,” he said. “This one is deserved. It’s on us.”

But he vowed to forge on with the rest of his agenda, saying: “I’m up to the challenge. We’re going to get this done.”

The White House’s turnabout comes as a growing number of congressional Democrats are expressing frustration with the president for the botched rollout of the health care law, including a poorly functioning website and the false promise he made that consumers who liked their existing health plans would be able to keep them.

On Friday, the Republican-controlled House is set to vote on a bill by Representative Fred Upton, Republican of Michigan and chairman of the Energy and Commerce Committee, that would allow Americans to keep their existing health coverage through 2014 without penalties. That left the White House needing to act to avoid having large numbers of Democrats vote for the Republican legislation.

A similar proposal, led by Senator Mary L. Landrieu, Democrat of Louisiana, and backed by roughly half a dozen other Democrats, is also underway in the Senate. Ms. Landrieu’s proposal would allow people to keep their current insurance permanently but, she said, is designed to encourage people to eventually switch to better insurance on the federal exchanges.

Some Senate Democrats said that the president’s changes did not go far enough and indicated that they would continue to support Ms. Landrieu’s measure.

Senate Republicans criticized the changes as unlikely to fix problems with the health care law.

Senator John Barrasso, Republican of Wyoming, said the president’s move was “a political Band-Aid, not a permanent cure for millions of Americans who are losing their coverage and seeing their premiums skyrocket.”

Gary M. Cohen, the federal health official in charge of insurance exchanges, described the president’s action as a form of “transitional relief.”

It applies only to individuals and small businesses that had coverage in effect on Oct. 1 of this year, Mr. Cohen said in a letter to state insurance commissioners. It does not apply to people who obtain new coverage after that date, he said.

Under its new policy, the White House is declaring that the Affordable Care Act does not require insurers to upgrade existing coverage for people who are now enrolled. Consumers could thus renew existing insurance policies even if they did not provide all the benefits and protections required by the 2010 health care law.

State insurance regulators said they were pleased that the administration was not allowing sales of old noncompliant policies to new customers.

It is not clear what prices will be charged by insurers for existing policies that are continued in force through 2014. Insurers generally do not have rates approved for the renewal of such coverage in 2014 because the policies were supposed to be terminated at the end of this year.

A White House official, asked if insurers could increase rates on these policies, said the question should be directed to insurers and insurance commissioners. “As a pragmatic matter,” the official said, “it will be up to insurance commissioners and states.”

If insurers want to increase rates on existing policies, they would, in most states, have to file the changes with state insurance commissioners, who could review the rates and take action under state law to determine if the rate increases were reasonable.

Obama administration officials did not say whether insurers could selectively renew policies for some consumers in some markets, but not others. For business reasons, insurers might want to drop some customers or withdraw from some markets.

Insurers have opposed legislation that would allow or require them to continue individual insurance policies that have been canceled because they do not meet the requirements of the Affordable Care Act.

Insurers fear that healthier policyholders would be more likely to take this option, leaving the new insurance exchanges with less healthy people who are more expensive to insure.