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States, not feds, are now key to making Obamacare work, insurers say

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President Obama's about-face last week may have blunted the immediate political blowback from his broken promise that Americans who like their insurance plans can keep them — a vow that turned out not to be true for millions across the country.

But despite the president's declaration that substandard health policies can continue being sold for another year, it will be state insurance commissioners working with private industry, not the federal government, who will determine whether Mr. Obama's latest proposal actually comes to fruition.

"We want to provide people coverage, but we do have challenges," said Karen Ignagni, CEO of America's Health Insurance Plans (AHIP), during an interview on "Fox News Sunday." AHIP is a national trade group representing the insurance industry.

"The state insurance commissioners ... will decide what the rules are in a particular state," Ms. Ignagni added.

Indeed, while the White House is pushing to restore canceled policies even if they don't meet the standards defined in Obamacare, there's no way to guarantee that will happen. Individual state insurance commissioners have the authority to decide whether such plans can be resurrected, making those state officials key to the future of Obamacare.

Washington state's insurance commissioner, for example, already has said he won't abide by the president's latest plan and instead will continue with Obamacare's new standards — a decision that surely will result in more people seeing their coverage dropped.

"It is a suggestion. It is not a ruling, and it certainly is not a law," former Sen. Ben Nelson, who now serves as CEO of the National Association of Insurance Commissioners, said of the administration's new proposal. Mr. Nelson also appeared on Fox News on Sunday.

"The insurance commissioners from every state will do their level best to try and take care of their people back home and try to do it within the confines of the law and within the actuarial considerations as well," Mr. Nelson said.

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