Obama praises health care law’s early effects

Starting now, insurance companies will no longer be permitted to exclude children because of preexisting health conditions, which the White House said could enable 72,000 uninsured to gain coverage. Insurers also will be prohibited from imposing lifetime limits on benefits.

The law will now forbid insurers to drop sick and costly customers after discovering technical mistakes on applications. It requires that they offer coverage to children under 26 on their parents’ policies.

The arrival of the long-awaited changes propelled President Obama, whose Democrats have struggled to exploit their signature achievement, into the backyard of Paul and Frances Brayshaw of Falls Church, Va., to explain his decision to pursue health care.

“The amount of vulnerability that was out there was horrendous,’’ Obama yesterday told a gathering of people chosen to illustrate the law’s new provisions.

He said he concluded that “we’ve just got to give people some basic peace of mind.’’

Obama also responded to Republican congressional leaders who have campaigned on a threat to repeal the act.

“I want them to look you in the eye,’’ he told his audience, and explain their opposition to a law that is projected to cover 32 million uninsured and reduce the deficit by $143 billion over 10 years.

House Republicans continued to question Obama’s assertions that the law will lower premiums, pointing to double-digit increases recently announced by many insurers. A blog posting on the website of the minority leader, Representative John A. Boehner of Ohio, predicted the law would “raise health care costs, explode the federal deficit, and create a byzantine bureaucracy.’’

The administration has estimated that premiums should rise no more than 2 percent because of the new consumer protections, and it warned this month that it would have “zero tolerance’’ for efforts to blame the law for larger increases.

It will take years to determine the act’s long-term impact on US health and on US politics. But Democrats did manage to front-load some notable benefits, while deferring the pain of tax increases and penalties until after the election.

Those changes have insurers in overdrive, cutting administrative staff, investing in big technology upgrades, and training employees to field the expected influx of customer inquiries.

Despite the talk among some Republicans of repealing all or part of the law, insurers say they cannot afford to put off the changes. Many said they were fundamentally altering their business models to cope.

“It is really the Manhattan Project because of the scale and the scope,’’ said Karen Ignagni, chief executive of America’s Health Insurance Plans, a trade group.

Companies are choosing to avoid some of the rules by no longer offering certain policies. Aetna, WellPoint, and Cigna, for example, have announced that they would stop selling new child-only policies, at least in some states. Ahead of the regulatory review, some also raised premiums this year.

The coming months should provide an important test of the legislation — and a dry run of sorts for the more far-reaching changes required by the law in 2014, when insurers will have to offer coverage to everyone and begin selling their plans on state-run exchanges.

Adjusting to the new terrain could push some insurers out of business, health care analysts say. In a setback to the bottom line, for example, insurers will no longer be able to pick and choose enrollees to avoid covering people who are likely to run up high medical bills, and many of the markets where they operate will become much less profitable.

“A lot of health plans will struggle and fail,’’ said Jeff Fusile, a health care partner at PricewaterhouseCoopers.

Blue Shield of California, which was an early proponent of requiring insurers to cover everyone, has trained about 2,500 people — nearly half of its workforce — on the impact of the new law. About 250 of the employees are leading teams responsible for reprogramming computer systems, determining the cost of new policies, and ensuring that the people answering phones have the correct responses to customer questions.

“The train has left the station, and we’d much rather be the ones with the engineer’s hat,’’ said Bruce Bodaken, the chief executive of Blue Shield of California, a nonprofit health plan based in San Francisco.