Obama's Health-Care Policy Pivots

As the Obama administration wraps up its second year of deploying provisions of the 2010 health-care overhaul law, a pattern has emerged. When it comes to issues that matter to insurers, providers, and employers, the president and his key aides show considerable flexibility, listening to objections and modifying proposed regulations. When it comes to ones that matter to consumers, they are usually less accommodating.

Example: The law requires insurers to spend as much as 85¢ of every premium dollar covering consumers’ claims and improving care, or else pay rebates. Insurers such as UnitedHealth Group dislike the idea and have sought exclusions from what counts as premiums. Among the exclusions the administration has agreed to: the dollars insurers use to pay most of their federal taxes. This, even though the chairmen of the congressional committees that drafted the law have told administration officials they never intended that.