If the last eight years have taught us anything, it should be that fixing our broken health insurance system won’t be easy — it will require multiple steps.
Bipartisan teams in the Senate and House are separately taking important first steps toward fixing the nation’s individual health insurance market.
Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderTrump is ‘open’ to ObamaCare fix, lawmakers say Tinker, scrap, or start over: Let states decide how to fix health care Overnight Health Care: Dem leaders keep distance from Sanders single-payer bill | Last-ditch ObamaCare repeal effort struggles for votes | Dems press Trump on ObamaCare outreach funds MORE (R-Tenn.) and Patty MurrayPatricia (Patty) Lynn MurrayTrump is ‘open’ to ObamaCare fix, lawmakers say Tinker, scrap, or start over: Let states decide how to fix health care Week ahead: Senate panel looks to quickly strike deal on ObamaCare fix MORE (D-Wash.), as well as some representatives in the House, are looking at ways to improve and strengthen state innovation waivers, which already exist in the Affordable Care Act (ACA), or ObamaCare. Also known as Section 1332 waivers, they give states flexibility to bypass some of the law’s requirements and to help develop localized ways to lower health-care costs, broaden coverage and improve treatment in their states.
Expanding this flexibility, which we have written about before, could be the key to unlocking some of the partisan gridlock surrounding health-care reform. If strengthened, these waivers could help governors and state legislatures across the nation innovate and find health insurance solutions that work best for their states. More conservative states could pursue market-oriented reforms, while more liberal states could pursue their own models.
But before states can adopt their own models, they must be assured there will be a market in place upon which to build. The most reasonable, politically feasible way to stabilize the market is to agree to reimburse insurers for providing coverage to those who cannot normally afford insurance — as the ACA requires.
Failing to do so could mean Americans may see their already expensive premiums rise by as much as 20 percent, their already high deductibles increase, and their already slim choices diminish as insurers retreat from even more markets.
While paying an estimated $7 billion to insurance companies for cost sharing reduction subsidies (CSR) is a tough pill for some Republicans to swallow, stabilizing the market should be even more important.
Many Republicans argue this problem was created by the Affordable Care Act, but if they allow the system to collapse now, Americans will know it was on their watch. It’s that simple.
Under the Affordable Care Act, health insurance companies must sign their agreements to participate in the markets and finalize their premiums in late September. If we have any chance of keeping 2018 premiums in check, Congress must provide certainty before then. With open enrollment fast approaching, the longer Congress waits, the greater the chance of people facing higher premiums or experiencing disruptions as they shop for coverage online in November.
Whether you believe that the nation’s health insurance law needs to be tweaked, overhauled or fully replaced, there are a couple things on which we can all agree.
First, health insurance premiums are too high and have continued to rise since the Affordable Care Act became law. Americans were not able to keep their preferred health insurance plans, and since health insurers are pulling out of markets across the country, many Americans no longer even have options from which to choose. Congress needs to reverse these trends.
Second, we know the Republican effort to comprehensively repeal and replace “ObamaCare” with one bill is not politically possible or strategically useful. Health care makes up nearly 20 percent of the nation’s economy. It personally touches the lives of all Americans. And for many, it is a matter of life and death.
Passing comprehensive partisan health-care legislation to fix the mistakes of the past is not the answer. The health-care industry is too complex to be reformed all at once.
The only way to fully cure the ails of the American health-care market — and make health care affordable for all Americans — is through finding bipartisan solutions to first immediately stabilize the market. Allowing states to better leverage Section 1332 waivers and reimbursing insurers for CSRs is critical to that end. Congress should then turn to finding longer-term bipartisan solutions to sustain the health-care market and address the underlying drivers of health-care costs.
The bipartisan, multi-pronged approach that is ongoing in the Senate and House right now is the best place to start. And the administration should do everything it can to support their efforts.
Newt Gingrich is a former Speaker of the U.S. House of Representatives, chairman of the board at Gingrich Productions and a Gallup Senior Scientist. Tom Daschle (D-S.D.) is a former United States Senate majority leader and founder and CEO of The Daschle Group, a public policy advisory of Baker Donelson. He is also the co-chair of the Bipartisan Policy Center Future of Health Care Initiative.