Jakob Rodgers, The Gazette
After months of legislative wrangling by Congressional Republicans to replace President Barack Obama’s health law, a bipartisan group of governors are trying something different:
Tinker with what’s already in place.
The plan released Thursday by Democratic Gov. John Hickenlooper and Ohio’s Republican Gov. John Kasich largely works within the framework of the nation’s existing health law, the Affordable Care Act.
Over and over, health experts used the same words to describe the proposed changes: “Incremental” and “pragmatic.”
“It’s a Band-Aid on part of the Affordable Care Act,” said Joe Hanel, a spokesman for the Colorado Health Institute, which analyzes legislative proposals. “A good Band-Aid, but it’s still just fairly small in scope.”
Health care policy experts largely offered guarded applause for the proposals – calling them long-overdue for a law that has gone without tweaks since its passage in 2009, unlike other major pieces of legislation.
And it quickly garnered praise from the Colorado Association of Health Plans and the Colorado Hospital Association.
The announcement comes as insurers across the nation seek more steep price hikes for 2018 – including 27 percent on average in Colorado – despite signs of market stability earlier this year. The uncertainty over Obamacare’s future has been a key reason for those requested rate increases, insurance executives and regulators say.
And it comes amid threats by President Donald Trump to end funding to a key subsidy program, which could spike rates up another 20 to 25 percent.
Thursday’s plan would affect only a fraction of Americans, because it only targets the individual market. That includes people without employer or government-based health insurance – roughly 7 percent of the nation’s population, according to the Kaiser Family Foundation.
The proposal calls for fixing the “family glitch,” which made it more difficult for some families who can’t afford their employers’ insurance to get federal subsidies on an exchange. And it called for streamlining the waiver process for states seeking more flexibility in how they oversee their insurance markets. As of July, only one state had been granted such a waiver, a Kaiser Family Foundation review shows.
Several of the governors’ ideas are untested, Hanel said, including allowing people in counties with only one exchange-based insurer to buy into the Federal Employee Benefit Program. Slightly more than a dozen Colorado counties would likely be affected.
And other proposals are unfunded, such as a call to implement a nationwide $15 billion state stability fund modeled off a program in Alaska that has helped ease the price of monthly premiums.
Already, Colorado insurance officials appear to be mulling the creation of such a fund, as are several other states, experts said.
Few ideas were new. And some provisions – such as extra payments to insurers with higher-cost enrollees – were previously part of the Affordable Care Act, but have since ended.
“Many of us have argued for years those changes need to be made,” said Bill Lindsay, who owns a consulting firm and recently served as chairman of the Colorado Commission on Affordable Health Care. “It’s very positive in that if it can get movement, maybe it can break the logjam.”
Left ignored, however, were concerns by experts that the health law’s tax credits do not help enough in the middle class – creating a key barrier to affordability for many purchasing their own insurance on state and national exchanges. The program, which offsets the cost of monthly premiums, is available to people earning up to four times the federal poverty limit. Some, however, say that bar is too low.
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