Opinion

Fixing Obamacare: It can be done

People in support of the Affordable Care Act rally in Washington, D.C. (Photo: Rena Schild)

Health care is something that should transcend political parties, ideological doctrines and beltway politics.  As crazy as that sounds, Democrats and Republicans have found ways in the past to bridge the partisan divide on major health policy issues such as insurance for low-income children, the expansion of Medicare to include drugs, and changing the way Medicare pays for health care services that emphasize value.

There’s no reason we can’t do the same to fix the Affordable Care Act, stabilize the marketplace and improve affordability and choice.

The battle cry from the ideological purists and hard-liners continues unabated.

Nearly 8 in 10 Americans say President Donald Trump and his Administration should be trying to make the health law work, according to a recent poll conducted by the Kaiser Family Foundation. Indeed, since the “Repeal and Replace” debate in Congress began 10 months ago, the health law is more popular than ever with 52% saying they hold a favorable view of it.

Of course, advocates and leaders from all sides of the political aisle are right to recognize there are significant fixes to the law that are sorely in demand.

The battle cry from the ideological purists and hard-liners continues unabated. On the Left, we hear the loud call for dismantling our current health care system and replacing it with a Single Payer model. On the Right, ardent conservatives continue to push for full repeal of the health reform law without any replacement. Neither scenario is in the cards for the foreseeable future.

If there’s no decision on federal cost sharing subsidies, Covered California must decide whether to apply a 12. 4 percent surcharge on premiums.

Amidst the uncertainty of what Congress and the President will do on health reform, health insurance plans are estimating their potential costs and exposure to risk for the 2018 calendar year.

It’s a dicey proposition in an industry that hates risk. But claims of an imminent meltdown are overblown and exaggerated.  Covered California recently announced that its average premiums will increase by an average of 12.5 percent next year. That may still be viewed as high for many families, but many other states will face a much steeper climb.

If there’s no agreement from the Trump Administration to provide the so-called “cost sharing reduction subsidies, the impact on premiums will be even higher. The Congressional Budget Office recently issued an independent analysis estimating a 20% average premium rate increase.  Higher premiums also mean the federal government will need to spend more on subsidies for health premiums. CBO estimates the added cost will increase the federal deficit by almost $200 billion for the next ten years.

And the clock is ticking. If there’s no decision on federal cost sharing subsidies, Covered California must decide whether to apply a 12. 4 percent surcharge on premiums. That deadline has now been extended to mid-October, which is at our doorstep.

“What have we to lose by trying to work together to find solutions?” — John McCain

Providing federal cost-sharing funds will go a long way in stabilizing an uncertain marketplace.  It’s an easy first step for which bipartisan support is growing.  It can also become a springboard for a new conversation about health care that focuses on what people really care about:  affordability, value and choice. Here are some other no brainers:

–Help Enroll More Healthy People.  There’s a lot of confusion right now about the Affordable Care Act and that is likely to depress the number of people who sign up for coverage when Open Enrollment begins on November 1st.  When more healthy people sign up, it’s easier to keep premium costs lower for everyone.  Advertising and in-person assistance can help.

–Extend Federal Funding for the Children’s Health Insurance Program (CHIP).  There’s strong bipartisan support for this federal program that provides affordable coverage for millions of American children, including over two million in California.  Current authorization of the program expired last month. Congress should reauthorize CHIP without allowing it to become a tool in a political leverage game.

–Stabilize Markets by Spreading Risk through Reinsurance.  A health insurance risk pool can be quickly drained if it faces big losses by having too many high cost patients – especially if the pool is small.  Reinsurance is a mechanism that spreads the risk more broadly.  It provided stability for the Affordable Care Act from 2014 through 2016, and could do so again.

Senators Lamar Alexander (R-Tenn) and Patty Murray (D-Wash), the chair and ranking Democrat of the Senate Committee responsible for health legislation, respectively, have already begun holding bipartisan hearings on health.  It’s a start and it’s about time.

“What have we to lose by trying to work together to find solutions?” Senator John McCain recently to his colleagues on the Senator Floor. “We are getting nothing done apart.”

Ed’s Note: David Panush, former external affairs director for Covered California, is president of California Health Policy Strategies. He can be contacted at d.panush@calhps.com.  John Kabateck, former executive director of the National Federation of Independent Business in California, is president of Kabateck Strategies. He can be contacted atjohn@kabstrat.com


  • parkprotector

    This article states “There’s no reason we can’t do the same to fix the Affordable Care Act,
    stabilize the marketplace and improve affordability and choice.” Yes there is…it is that it doesn’t serve the political purpose of the Republican party. In fact, a compromise that leaves any part of Obamacare in place is seen as undercutting their platform. Funny how that can happen when you get too far out on the political limb. Instead of working to develop a sustainable healthcare plan that would protect the largest number of Americans possible, their focus has been to work to destroy the only current viable, though seriously flawed, option. By placing political gain above our citizens’ health, they have shown where their loyalties really lie…in power and pocketbooks, reelection and donor loyalty. I won’t say that you shouldn’t continue to support those who currently represent you and this self-serving philosophy, because they don’t represent you – they only represent themselves. Instead I would encourage you to vote for those who have the best interests of you, your children, and your neighbors at heart. This is a problem that MUST be solved for the good of our nation and its citizens, and should not be looked at as a stepping stone to political gain.

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