States divided over letting insurers extend canceled plans

Former Senator Nelson sounds off


This is a rush transcript from "Your World," December 4, 2013. This copy may not be in its final form and may be updated.

NEIL CAVUTO, HOST: Well, it's not just young people. As John pointed out, President Obama is also trying to convince a number of state insurance commissioners, in fact, all of them, to get on board with a plan to extend those canceled plans, at least for a year.

Ben Nelson, of course, former Democratic senator who supported the health care law, now he probably has a more importance function these days as the head of the National Association of Insurance Commissioners. They all recently met with the president, or at least key people, yourself included.

You were telling me it's split among...


BEN NELSON, D-FORMER U.S. SENATOR: Well, there are 23 states where the commissioners and/or the legislatures and the governor have decided to go along with the president's recommendation or his suggestion that the coverage be extended.

And 23 states have decided that they either don't have the authority or it would be inappropriate based on what laws have been passed in their state, because, in some instances, they passed a law saying that people had to get in to the plan, and so they are getting into the plan as...


CAVUTO: They would be breaking their own law.

NELSON: They would be breaking their own law.

CAVUTO: So for those 23, not -- the others are undecided, I guess.

What happens to the folks in that state who the president said, well, you can stay on your plan for another year? They can't, right?

NELSON: They can. They can stay on their plan.

And what that does, it raises serious questions about the actuarial content of that plan. Where you have mostly young people or where you have people with health care conditions, once you get an adverse selection pool going, that will adversely impact rates.

And there are all kinds of questions, technical questions we won't go into about whether you keep the rate as it is for this year or whether you will adjust the rate for next year, and how long does this go on?


CAVUTO: Did you envision any of this when you voted for this?

NELSON: I don't think anybody could have.


CAVUTO: I mean, it's a lot worse than you thought, right?


NELSON: Well, let me put it this way. I think the rollout created unnecessary confusion when you look back, and it's been difficult correcting that.


CAVUTO: But when you were crunching the numbers back then, Senator...


CAVUTO: ... and voting on this, did any of your colleagues say, you know, truth be told, when the president's saying you can keep your doctor and all that, there's no way, there's no way?

NELSON: Sure, we said it.

CAVUTO: You did?


CAVUTO: Did you say it to him?

NELSON: We said it to the appropriate people.


CAVUTO: Did they tell him?

NELSON: I don't know.

He says that he was aware of part of it, and he's given his own explanation. I don't think so.

CAVUTO: Do you think he lied?


I'm not -- I'm not going to go into saying anything about the president of the United States. You know, he has his own explanation. We understand that. And he's -- he's given it. What I do know is that there were several of us who did say that that would be a very difficult promise to keep.

CAVUTO: Well, what do you think it's going end to up then?

I was asking Michele Bachmann earlier. It's really in the end, looking at this in layman's term, how many people benefit vs. how many do not. And the argument was that everyone was going to benefit, by and large, when this was sold. And now it looks like a good chunk of people are not going to benefit. You think more will benefit or fewer?

NELSON: I don't think anybody knows at the moment what the rates will ultimately be or when...


CAVUTO: But they're up a lot for a lot of people.

NELSON: Well, no, no, but, ultimately, how that will all play out. Competition...

CAVUTO: Well, what do you do for those who are finding that when even when they do get coverage, if they have been kicked off the plan or whatever, they're paying a lot more for it or a lot limited choices, or -- or sort of a one-size-fits-all? But, bottom line, they're -- they're burned.

NELSON: Well, you know, the one thing that people do need to focus on is that there's no longer a lifetime or an annual limitation or a cap on benefits...


CAVUTO: No, no, no, there's a lot of great stuff here, Senator.


CAVUTO: But the lifetime benefit, that's fine. But covering those preexisting conditions, I love that one.

But you knew at the time, and I'm sure a lot of your colleagues at the time, that you don't get something for nothing, right?

NELSON: Ah, but what -- there is something here that hasn't been discussed much is the medical loss ratio, that 85 percent of the premium or 85 cents out of every premium dollar needs to be paid out in benefits, or returned, and has already been processed sort of in a place where last year people got rebates.


CAVUTO: But not enough. Most right now, early on, are paying a lot more. Now, do you think that's going to reverse itself?

NELSON: Well, I think that's where it will even out at some point with competition. What will be the advantage in overcharging? You can't keep the money.

CAVUTO: Do you regret any of this?

NELSON: Look, you can't -- you don't get a lot of do-overs in life.


CAVUTO: If you did, if you did?

NELSON: No, no, you know, I don't think it's fair for me to go back and talk about it that way.


CAVUTO: I talked to some of your colleagues off the record, because they don't say this on the record. Yes, I regret it.

NELSON: Well, I think I regret a lot of things that have happened, like the bad rollout, the fact that young people have been told that it's better to stay off the plan than it is to get on the plan.

CAVUTO: Do you think the president was out to lunch on this?

NELSON: No, I don't.

CAVUTO: Do you think that the White House in general didn't appreciate the gravity?

NELSON: I'm not going to get -- I'm not going to get engaged in that kind of a blame game.


CAVUTO: Not any blame, but it was his pet project, it was his baby. This was his JFK space program, right?

NELSON: Well, I think what you need to think about is that sometimes you attempt to do things.

Now, let's go back to the prescription drug benefit, Part D of Medicare. I didn't think that would go out smoothly, and it did. You don't always -- can't always predict.


CAVUTO: Well, it didn't go out smoothly. It finished up better than it started. But you're right.

NELSON: Well, OK, finished up better than it started. But it wasn't a bad rollout.

CAVUTO: But you're going to give the benefit of the doubt like Bill Clinton that this will sort itself out?


NELSON: Well, I think it will sort itself out.


NELSON: Ultimately, people will have to come together and find solutions, as opposed to blaming and pointing fingers.

That won't get us where we want to be. And that's why the commissioners...


NELSON: ... are focused on taking care of folks back home in the best way they can figure out how to do it.

CAVUTO: Well, for those who are not, they're in a pickle here.

But, Senator, thank you very much.

NELSON: Thank you.

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