JUDY WOODRUFF: Congress took the primary step today towards permitting Americans hold on to their existing health insurance. But the bill that passed the House might be going nowhere fast.

NewsHour legislative reporter Kwame Holman begins our coverage.

REP. MICHAEL BURGESS, R-Texas: Exactly what has been checked out after the American student in the Affordable Treatment Act will certainly not be resolved by this action today. It is simply to quit the bleeding.

KWAME HOLMAN: The one-page bill pressed via by House Republicans would certainly permit those that intend to keep or restore their health plans. The Associated Press showed additional than four million policies have been canceled up until now.

Michael Citizen of Texas:

MICHAEL BURGESS: Any kind of excellent triage physician knows prior to they could fully treat or treat the client, they need to handle the immediate troubles. In this case, they have to quit the hemorrhage of individuals losing their personal health plan as a result of the Affordable Treatment Act.

KWAME HOLMAN: However the expense likewise goes a crucial step additionally. It permits insurance coverage business market brand-new customers plans that disappoint the government requirements. California Democrat Henry Waxman cautioned that provision would certainly undermine the entire regimen.

REP. HENRY WAXMAN, D-Calif.: It will certainly destabilize the health plan exchanges, increase premiums, and remain to enable insurance companies to discriminate on the basis of preexisting disorders. Under the Republican bill, insurance providers could cherry-pick the very best threats and destabilize the insurance coverage market for everybody else.

KWAME HOLMAN: Eventually, the ballot was 261-157, with 39 Democrats electing the Republican expense.

MAN: The expense is passed.

KWAME HOLMAN: White House officials was afraid more Democratic defections before the president announced he’s providing insurance policy firms the alternative of prolonging current plans via 2014.

In Detroit today, Kathleen Sebelius, the secretary of health and human services, said she thinks the majority of individuals will go for brand-new plans.

KATHLEEN SEBELIUS, U.S. Wellness and Person Solutions Secretary: We just wish that, on harmony, student find either affordable coverage visiting their prepare for an extra year and have a shift year– and that’s exactly what this really is– it’s type of a bridge year– or locate for that, for far much better protection, they are better off in the brand-new industry.

KWAME HOLMAN: Residence Republicans insisted today the president’s administrative modification is not sufficient, that it takes the pressure of legislation to do just what’s required. However the White Residence advised the head of state will veto the GOP costs if it ever before reaches his desk. And anyway, the action stands little chance of gathering a bulk in the Democratic-held Senate.

Instead, a handful of Us senate Democrats led by Louisiana’s Mary Landrieu is driving its own bill. It requires companies to ongoing existing insurance coverage, but unlike your house costs, it’s restricted to existing consumers. And unlike the one-year restriction on the plan the president announced last night, the plans could possibly continue to be basically indefinitely, all this as the head of state met with health plan Chief executive officers at the White House this mid-day, insisting them to restore canceled plans.

JUDY WOODRUFF: As Kwame stated in his record, the head of state’s action the other day on the problem of canceled plans permits insurance firms to extend those current plans via 2014. Yet it does not need them to do so.

Now, among the major inquiries is whether insurance providers will certainly accompany this and, if they do, what problems they have concerning transforming things once again.

Hari Sreenivasan gets that part of the story.

HARI SREENIVASAN: Julie Appleby follows these concerns closely for Kaiser Wellness News, an independent not-for-profit information organization. It is not associated with the Kaiser Permanente insurance coverage company.

So, I understand that we saw images of the president meeting with the Chief executive officers today. Has the insurance policy sector appeared and made a declaration on exactly how they’re visiting take these modifications?

JULIE APPLEBY, Kaiser Wellness Information: They’re being very careful now.

A great deal of them, as a result of the logistics included, due to the fact that this is optional, they are claiming they’re researching this, however they haven’t made any kind of decisions. A great deal of them are very noncommittal regarding it. We have actually heard from a few insurance firms, like The sunshine state Blue, Aetna, Blue Cross/Blue Shield of North Carolina, that say that they do intend to enable some of these policies to be renewed.

Yet we’re likewise hearing from the industry’s field lobby that this is a bad suggestion. They do not like the idea. They say it might interrupt the marketplace and can cause issues down free throw line that could induce greater fees in the future.

HARI SREENIVASAN: So, it’s a combined bag relying on the insurance policy companies, and there’s no way to interview every one of these.

JULIE APPLEBY: Yes.

HARI SREENIVASAN: So, let’s chat regarding several of the functional challenges that these insurance coverage firms have now. The amount of is it going to cost them when it pertains to transforming these methods around? They have actually taken a minimum of a year, a year-and-a-half to attempt to figure out the best ways to abide by the ACA.

JULIE APPLEBY: That is among things they’re battling with. Is this worth it to them to experience the management inconvenience of finding out, the number of plans do we wish to restore? Whiches? The amount of will it set you back? Do we wish to raise premiums for these policies?

If they want to increase excellents, which they often do– when a policy turns up for renewal, there’s normally a costs boost. But that calls for that they submit that with their state insurance policy commissioner, obtain approval in lots of cases, and placed it in to effect. That is among the inquiries they’re battling with. Exactly how would we do that? Do we have time to do that?

Keep in mind, a great deal of the plans end by the end of the year. Therefore if individuals wish to have protection starting January 1, they basically have had the ability to have this done by December 15. That’s only a month from now and that is not a great deal of time. So, that is among the things that the insurance companies are wrestling with in this procedure.

HARI SREENIVASAN: One of the reasons for all these timelines was to encourage student to obtain into these healthcare exchanges. The exchanges need a good cross-section of individuals, young healthy individuals, aged student, and so on.

If this expansion or this delay takes place, what happens to the swimming pool of individuals in these exchanges?

JULIE APPLEBY: That’s one of the worries that the insurers and the actuaries and a few of the state insurance coverage commissioners also have specified is, exactly what occurs? Is this visiting keep more individuals that are younger and healthier, for instance, from that pool that’s entering those brand-new marketplaces?

And if that takes place, if the youthful student or the healthier student make a decision to hang on to these policies since they’re much less detailed and possibly a little bit more economical, then that could leave older and sicker people in the marketplace and that over time might increase costs in that marketplace, which could be a big issue later on.

HARI SREENIVASAN: And then aid explain the function that the state insurance commissioners play, since they’re not an untamed card, yet they’re an extremely important actor in rolling these points out.

JULIE APPLEBY: That’s right. That’s right. And not all of them intend to do this. We have listened to from numerous states that claim, yes, we intend to.

And we have actually learnt through many that don’t. Washington State, as an example, does not wish to do this. The insurance policy commissioner there said we ratified some of these new customer arrangements. We need these brand-new strategies to have a lot of new benefits. That’s why we’re doing away with the old strategies, and we think that consumers are visiting benefit from the brand-new strategies, so we do not intend to alter this.

But various other states are saying that, yes, we desire to try it. So, Florida, as an example, has actually claimed, yes, we’re visiting let student restore the policies. So, these insurance policy commissioners are going to belong to this decision, and they’re not consentaneous in just what they’re going to do.

HARI SREENIVASAN: And is there any type of type of a timeline or due date that the insurance commissioners have to make a decision by?

JULIE APPLEBY: Well, once more, it obtains back to, when do these plans start?

So, for some individuals, these plans expire at the end of December, so for them, the stress is on. But just what the head of state claimed is that even plans that end say, in January, or February or March could possibly be renewed for another year. For those plans, there could be a little additional time to decide.

HARI SREENIVASAN: And, inevitably, exactly what about the sort of end user, the person who is assuming concerning delving into these exchanges? Should this offer them pause? Should they be awaiting some type of interaction from an insurance brand?

JULIE APPLEBY: You understand, the folks that are– just what consumer proponents are telling me is that if you have had a canceled policy, you could wish to get in touch with your insurance provider whether they’re going to allow to you renew it or not. That would be the primary step.

And after that the other point that consumer advocates point out is that you should look at your on the internet marketplace, whether it’s your state one or the government one, to see if you may get a much better bargain through that industry, either a more thorough policy or a subsidy. But that’s that is among things that student need to check.

HARI SREENIVASAN: Always immediately, Julie Appleby, thanks a lot.

JULIE APPLEBY: Thanks.