Governors Send Letter to Congressional Leadership Recommending Health Insurance Reform
Late last month, Governors John Hickenlooper (D-CO) and John Kasich (R-OH) led a bipartisan letter to Senate and House leadership recommending changes to improve affordability and restore stability to the individual health insurance market. Additional signers included Governors from Nevada, Pennsylvania, Alaska, Virginia, Louisiana, and Montana. The letter specifically noted the importance of ensuring access to care for those with mental illness and addiction.
The Governors made three major recommendations to Congressional leadership:
- Initiate immediate federal action to stabilize markets. While Congress is working to strengthen the insurance market, the Governors recommended that consumers have affordable options made immediately available to them. Some actionable steps include having the Trump Administration commit to cost sharing reduction payments through 2019 and Congress creating a $15 billion temporary stability fund. The letter also recommended offering insurers in underserved counties exemptions from the Affordable Care Act’s (ACA) health insurance tax on their exchange plans, and maintaining the individual mandate until an appropriate replacement can be identified.
- Maintain an active federal/state partnership to improve the health system. The Governors urged Congressional leaders to work with states, and overcome the constraints that federal law and regulation place on many state reforms. Within this section, the Governors recommended that the federal government not duplicate efforts, and thus free up states to regulate their own insurance markets under the ACA. They also suggested Congress make a clear commitment to value-based health care purchasing, as well as informing consumers more about their options for care.
- Create reforms that preserve recent coverage gains and control cost. One major recommendation made by the Governors under this goal was fixing the “family glitch” by making insurance more affordable, increasing outreach to young people, and thus reducing the number of those who are uninsured. They also suggested Congress promote “appropriate enrollment”, and strengthen federal risk sharing mechanisms, such as risk adjustments and reinsurance.
ACA 1332 WAIVERS
The letter also focused on the ACA’s 1332 waiver, which allows states to customize requirements of federal health coverage, provided they maintain baseline aspects of the Affordable Care Act. The Governors recommended streamlining the 1332 waiver submission and approval process by eliminating the three-month waiting period and allowing Governors to submit the application without approval of their state legislatures. Additionally, the letter recommends permitting states flexibility with the federal budget neutrality requirements of the 1332 waivers by allowing them to combine the 1115 and 1332 waivers, rather than keeping them separate. More about the 1332 waiver can be found here.