Since attempts to dismantle the Affordable Care Act have stalled, federal officials and lawmakers must now focus on stabilizing the individual health insurance market, according to three former secretaries of the Department of Health and Human Services.
Kathleen Sebelius, a Democrat, and Republicans Mike Leavitt and Tommy Thompson all told the Associated Press that they believe the Trump administration and Congress should provide clarity on the future of cost-sharing reduction payments. The CSR program is at the center of a court battle concerning whether they are legally funded.
The administration recently confirmed that it would make payments to insurers for August, but has not committed to funding the subsidies long term, making it difficult for insurers to decide their plan pricing and market participation for 2018.
Thompson, who led HHS during former President George W. Bush’s first term, told AP that it would be unwise to further destabilize the insurance marketplaces. He thinks President Donald Trump and congressional leaders from both parties should meet to hammer out a deal on healthcare that Congress can then advance.
Leavitt and Sebelius, though, think states are more likely to play a leading role—especially through the use of waivers created under the ACA.
Republicans “can make changes that signal a new ideological direction without generating a logistical and political mess,” noted Leavitt, who led HHS during Bush’s second term.
But Sebelius, who served during former President Barack Obama’s first term, cautioned that waivers shouldn’t be used to undermine federal consumer protections that are part of the ACA.
Lawmakers don’t return from their recess until Sept. 5, after which they will have just a small window to craft a legislative fix for the ACA marketplaces. Insurers have to finalize their 2018 plans by Sept. 27.
Sen. Lamar Alexander, R-Tenn., and Sen. Patty Murray, D-Wash., are working on a bipartisan plan ahead of healthcare hearings planned in early September, but an alternate plan championed by Sen. Lindsey Graham, R-S.C., and Sen. Bill Cassidy, R-La., is gaining steam, according to The Wall Street Journal.
The Graham-Cassidy plan would reroute funding earmarked for the ACA directly to states in the form of annual block grants, but it would still necessitate deep spending cuts.