A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules.
In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces.
Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers. The House sued the Obama administration over the subsidies’ legality, and President Trump has repeatedly suggested that he might halt the payments — sending tremors through insurance companies in the marketplaces.
Five days before the House and Senate return to Washington, the governors also recommend preserving “for now” the ACA’s requirement that most Americans carry health insurance. Though this rule is unpopular, they concluded that it is “for the time being … perhaps the most important incentive for healthy people to enroll in coverage.”
The proposal also calls for a federal fund, to be available for two years, to buffer insurers from high-cost customers, and for the government to foster competition in ACA marketplaces by encouraging insurers to move into counties with only one company. Those that do would have the law’s insurer taxes waived on health plans sold in those locations.
Led by Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D), the blueprint essentially fleshes out the contours of four principals that many of the same governors recommended to Senate leaders in June. It focuses on the insurance market for individuals and families that buy coverage on their own — a fraction of the country’s consumers with private insurance but a perennially shaky part of the industry that the ACA was designed to strengthen.
Greg Moody, a longtime health-care aide to Kasich, said the blueprint is also an acknowledgment of the failure this year of Republicans who control Congress to deliver on their years-long goal of replacing the ACA. “We’ve recently seen how difficult that is,” Moody said.
The blueprint envisions a quick federal boost to shore up the marketplace for the coming year, while deferring to states longer term to experiment with potential changes in insurance subsidies, for instance, or different forms of penalties for consumers who drop coverage.
The proposal was released Thursday so that it would attract attention before two days of hearings scheduled next week by the Senate’s health committee, which will explore bipartisan ideas for improving the law and its marketplaces.
The other governors who signed on are Brian Sandoval (R-Nev.), Tom Wolf (D-Pa.), Bill Walker (I-Alaska), Terry McAuliffe (D-Va.), John Bel Edwards (D-La.) and Steve Bullock (D-Mont.).