Some State Insurance Officials Decline to Meet With Obama In a sign of growing discord among the nation's insurance commissioners over President Obama's proposed modifications to the new health care law, some members of their main industry association are refusing to attend a meeting with the president Wednesday afternoon to discuss the issue. On Tuesday, Jim Donelon, head of the National Association of Insurance Commissioners, sent a note to the country's state insurance commissioners saying he and a four other commissioners were scheduled to see the president to discuss the industry's concerns, according to people with knowledge of the invitation, who spoke on condition of anonymity. Just days ago, Mr. Obama, trying to make good on an earlier promise he had made, said millions of consumers should be able to keep their old insurance plans for another year - even if the old plans did not meet the requirements of his administration's new health care law. The announcement has caused a stir among insurance companies, which write the policies, and state insurance regulators, who typically have final say over whether the old policies can be sold and what insurers can charge for them. The companies said the proposal could increase the cost of policies in future years and has created a logistical nightmare for them. Some states, like Florida, have said they will allow consumers to renew old policies, but others, including Washington State and Indiana, have said they will not adopt Mr. Obama's proposal. Mr. Donelon, according to the people briefed on his email to the National Association of Insurance Commissioners, said he would attend the meeting and had also invited fellow insurance commissioners Adam Hamm, Sandy Praeger, Thomas B. Leonardi and Wayne Goodwin. Aides to Mr. Leonardi, of Connecticut, and Mr. Goodwin, of North Carolina, confirmed they are attending the meeting. Mr. Hamm, the insurance commissioner from North Dakota, and Ms. Praeger, from Kansas, however, are not going, according to an email sent by them and a handful of other commissioners on Tuesday to their colleagues around the country. "We made this difficult decision not to attend due to the fact that we were either not invited to do so, or were invited but have declined, but in all cases we have serious reservations about both the process and the policy issues surrounding such an important meeting," read the letter sent around 8:30 p.m. Tuesday and given to The New York Times. The email added that the meeting with the president had not been discussed "in any meaningful way" with the commissioners as a group "nor have we worked to build consensus among the members about what our positions will be in the meeting." Mr. Hamm, in a statement, said he had no choice but to decline. It's an honor to have been invited to meet with the president, and I would enjoy the opportunity to do so in the future. However, because the topic for the meeting (Affordable Care Act) is so delicate and potentially divisive among the nation's insurance commissioners, a meaningful discussion between all the commissioners needs to take place before a meeting with the president. Unfortunately, that did not happen so I had to respectfully decline to participate in today's meeting. A spokesman for Ms. Praeger said in an email that "the commissioner and department personnel are conferring with companies on how the president's changes might be implemented here in Kansas, and those discussions are keeping her close." Ms. Praeger's decision not to attend the meeting is particularly noteworthy, as she has a job once held by Kathleen Sebelius, the secretary of health and human services, who has been widely blamed for some of the missteps in the adoption of the Affordable Care Act. Mr. Donelon, reached Tuesday night, declined to comment on the concern some of his members have about attending the meeting. "I am not going to comment on the opinions of some insurance commissioners," he said. White House officials said the closed-door afternoon meeting with the insurance commissioners was intended to provide a forum for a discussion about "implementation issues associated with the Affordable Care Act and other insurance-related issues." A spokeswoman for the White House declined to comment on the meeting or the guest list in advance. Last week many of the country's big insurers met with Mr. Obama to discuss his proposal. Some representatives of the insurance industry have said the president's idea is fraught with problems and could actually lead to higher insurance prices in 2015 and beyond by skewing the mix of customers in the new insurance marketplace. Their worry is that because of the president's proposal, people who currently have cheaper insurance - because their plans have fewer benefits - will now be able to keep them, rather than buying new policies as required by the Affordable Care Act. If those people stick with their old plans, the new federal marketplaces will have more sick and old people, which will force prices to rise.