Gov. Tom Wolf isn’t giving up on the Affordable Care Act and, in a letter to congressional leadership, Pennsylvania’s chief executive joined seven other governors in outlining recommendations to improve the health insurance market.
The letter comes as talk of replacing and repealing former President Barack Obama’s signature legislation has cooled somewhat after several attempts by President Donald Trump and Republicans in both houses to get rid of the law have thus far failed.
“We must protect the gains we have made in Pennsylvania and many other states, but we all recognize that there are commonsense changes that can make the cost of care less expensive and more accessible,” Wolf said in a statement.
“Instead of working to destabilize the health insurance system, Congress should work with governors to improve the system for all Americans,” he said.
The governors who joined Wolf, a Democrat, are John Kasich (R-Ohio), Jon Bel Edwards (D-Louisiana), Steve Bullock (D-Montana), Bill Walker (I-Alaska), John Hickenlooper (D-Colorado), and Terry McAuliffe (D-Virginia).
The group outlined what they called concrete recommendations that would strengthen and improve Obamacare, legislation Trump has most recently threatened to allow to crumble by revoking federal funding.
Wolf, who’s expected to dispatch Acting Secretary of Human Services Teresa Miller to testify this week at a Senate committee hearing to amplify the need for changes to stabilize local markets and those around the country, has long been a supporter of Obamacare.
“The recommendations [from the governors] include immediate federal action to stabilize the markets, responsible reforms that preserve recent coverage gains and control costs, and an active federal and state partnership based on innovation and a shared commitment to improve overall health system performance,” Wolf said in his statement.
Insurers have until the end of this month to make final decisions about participating in marketplaces and Congress and the Administration need to send a strong signal now that the individual market will remain viable this year, next year, and into the future, the governors said.
They have urged Congress to fund cost sharing reduction payments, which have been identified as an urgent necessity by the National Association of Insurance Commissioners, the National Governors Association, and the United States Chamber of Commerce.
The Congressional Budget Office has estimated that not making these payments would drive up premiums by as much as 25 percent and increase the federal deficit $194 billion over 10 years.
Congress should also create a fund that states can use to make reinsurance programs or similar efforts that reduce premiums and limit losses for providing coverage, Wolf and his fellow governors said.
“We recommend funding the program for at least two years and fully offsetting the cost so it does not add to the deficit,” the governors wrote in the letter.
Additionally, the governors agreed that Congress should foster competition and choice in counties where consumers lack options because there’s just one carrier on the exchange.
They also have urged keeping the individual mandate for now to prevent a rapid exit of additional carriers from the marketplace.
Other fixes outlined in the letter include maximizing market participation; promoting appropriate enrollment; stabilizing the risk pools; reducing cost through coverage redesign; improving the regulatory environment; supporting state innovation waivers; and controlling costs through payment innovation.
“Coverage is important, and coverage reforms can help contain costs, but eventually our nation needs to confront the underlying market dynamics that are driving unsustainable increases in the cost of care,” the governors wrote in the letter.
“With the support of the federal government, states are resetting the basic rules of health care competition to pay providers based on the quality, not the quantity of care they give patients,” he said. “This is true in our states, where we are increasing access to comprehensive primary care and reducing the incentive to overuse unnecessary services within high cost episodes of care.”