Former Sen. Ben Nelson on ObamaCare enrollment, delays

Lawmaker who cast key ObamaCare vote speaks out

This is a rush transcript from "Your world" March 7, 2014. This copy may not be in its final form and may be updated.

NEIL CAVUTO, HOST: I do want to bring people up to speed on this and what this means.

It is still early, and to the White House's point, maybe more of the uninsured could -- could sign on. But only a quarter of those signing on to ObamaCare, as it's chiefly known, and the exchanges, as they're specifically known, is not what was supposed to happen.

So, the uninsured, by and large, still not crazy over it, a lot of young people still not signing up for it.

Does my next guest regret backing it?

Former Democratic Senator Ben Nelson cast one of the deciding votes that made the health care bill a law. He heads up the National Association of Insurance Commissioners, who, ironically, vote yea or nay on some of these extensions the president and Health and Human Services have been advocating.

Senator, do you ever regret that vote when you hear stuff like this?

BEN NELSON, D-FORMER U.S. SENATOR: There are no do-overs in this business.

What you know from our previous interviews, we got the single-payer system out of it, the public option. So there were a lot of things that would have made a bill a lot worse with a single -- with a simple majority vote under the resolution of the budget.

So, you have to look at all the aspects of it. But I thought I was here to talk to you about what the states are trying to do to make sure that the people back home get the best opportunities that they can have.

CAVUTO: Well, you are, but this is all part of the same picture, I guess, to that earlier question. And we get into what the states and what they are going to do and make sure everything goes smooth with these exchanges.

Do you ever regret that vote? Do you think or could you have envisioned these problems?

NELSON: Well, any kind of maximum legislation that is large in its implications is going to face some challenges. There's no doubt about it.

Now, do we all wish that this had gone more smoothly? The answer is obvious. Yes. The states wish it would have -- for wherever there are states' exchanges, the federal exchange, we wish that would have been better. Those are all obvious thoughts that we have today across the country.

But what I can tell you is that states are working very hard to make the implications to the people back home the best that they can possibly do so. I'm concerned, states are concerned that when you change the system at this point in time, as back in November, that you create two risk pools, and you perpetuate risk pools, which you that don't have the actuarial implications that you had before. And...

(CROSSTALK)

CAVUTO: Well, what you're saying there -- what you're saying there, Senator -- you're a very smart guy, but you can lose me quite easily.

What you're saying is, you better be careful what you wish for, you might just get it, and while it might sound good after the fact to put the genie back in the bottle, and say, all right, if you like your plan, even if it's a substandard plan, even if it doesn't make all the qualifications of the president's plan, you can hang on to it for an additional year and insurance companies can still offer them for an additional year, but it does complicate it...

NELSON: It does complicate it.

CAVUTO: ... because the states are already working under this.

(CROSSTALK)

CAVUTO: So, what's going to happen?

NELSON: Well, I -- I don't think we know entirely, but what I think will happen procedurally is, the insurance companies will have to go back and calculate new actuarial numbers to see what the implications are to the premiums and...

(CROSSTALK)

CAVUTO: But they don't have to do that. Right? They don't have to, just like commissioners don't have to, right?

NELSON: No. No. No, no. If they elect to go along with it...

CAVUTO: Right.

NELSON: ... if the states elect to go along with it, that is what will happen.

There are -- about half the states have decided not to go along with it after the decision was made in November by the White House. So I don't -- we don't know at this point in time whether any of the states will change their direction on this or whether they will stay where they are.

But the extension does run the risk of perpetuating more than one risk pool, which -- which can adversely affect selection, so that more sick people might be in it, or you might have different premiums and premium increases. Uncertainty is not good in the insurance business.

CAVUTO: Do your commissioners, or fellow commissioners, when you talk to them and they hear of another extension, whether it be something for small business or whether it be for insurance planes that don't meet the -- the strict standards of the new law, delaying it another year, do they just roll their eyes and...

(LAUGHTER)

CAVUTO: ... just say, oh, my gosh, what are we going to do? Or do they get themselves set to think, all right, we're going to have a couple of years here of a myriad of different plans, a myriad of different standards, a myriad of different insurance pools and a myriad of messes?

NELSON: Well, you're -- you're going to have a myriad of different attitudes by -- by state regulators.

And the NAIC, our office, supports those commissioners and their state offices with the -- with the best support we can do.

CAVUTO: Hmm.

NELSON: We don't take positions with respect to the law. We just try to help administer in any way we can, so that their -- their job is made easier for -- for the people back home.

CAVUTO: Finally, Senator, real quickly -- and I appreciate your time -- isn't...

(CROSSTALK)

CAVUTO: ... that a kick, if we did all this and so many who were uninsured remain uninsured? NELSON: Well, I don't think anybody can -- can predict what the future will be or when that might change.

I think this has taken a lot longer for things to materialize and people to get on than anybody perhaps projected -- projected, unless there were those who were saying it's going to fail. So, I don't think we really know.

But I do hope that people who are uninsured will take the opportunity to become insured. It's -- it's in their best interests, regardless of what they think of the law.

CAVUTO: Right.

NELSON: People should have health insurance. It's that simple.

CAVUTO: Senator, thank you for taking the time. I appreciate it.

NELSON: Again, thank you, Neil. It's always good to be with you.

CAVUTO: All right.

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