America faces an urgent crisis in its health-care system. Costs are skyrocketing and choices are disappearing on the individual and small-group markets. Many people now confront the real challenge of having no choice in their health coverage. This year more than 1,000 counties had only one insurer in the ObamaCare market, meaning millions of Americans had no meaningful choice. Meanwhile, the insurers that did stay in the market increased premiums for their midlevel plans by an average of 25%. Premiums on the individual market are up about $3,000 since ObamaCare was implemented.
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Senate Republicans on Tuesday delayed a vote on their health-care bill until after the July 4 recess, and the timidity and opportunism of too many Senators suggest they may never get 50 GOP votes. We hope they understand that if they fail, Republicans will be entrusting their political health-care future to the brutal generosity of Democratic Leader Chuck Schumer. The idea persists in some media and GOP ranks that if the Senate bill dies, this will produce a blossoming of bipartisanship. But if Republicans fail, Democrats will have zero political incentive to cooperate except on their policy terms. Americans know that Republicans run Congress and the White House, and that they promised to do something about the problems of ObamaCare. Do Republicans really believe voters in 2018 will blame GOP failure on the President who left town two years ago?
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For decades American conservatives have sought to restore meaning to the 10th Amendment, which recognizes the states’ right to manage their affairs free from Washington’s interference. Passing the Republican Senate’s health-care bill would represent historic progress toward that goal.
Governors and state legislatures ask Washington every year for the right to receive their Medicaid funds in the form of a block grant, which would give them autonomy to manage the spending as they see fit. The Senate bill, for the first time, would allow that.
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Experts don’t always agree, but eight of us (including Grace-Marie Turner) from right and left found common ground on key health reform recommendations. We agreed that states should be given greater authority to configure and redirect revenue streams from Medicaid, CHIP and private insurance; that the existing tax exclusion for employer-sponsored health benefits should have reasonable limits; and that states need new authority to simplify their insurance markets and develop fiscally sound and affordable coverage options for their most vulnerable citizens, providing more help to those who can least afford the premiums.
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Senate Republicans released their draft bill to repeal and replace ObamaCare on Thursday, and Majority Leader Mitch McConnell is hoping for a vote next week. The binary choice now is between pushing past the media and Democratic flak to pass a historic achievement, or wilting under the pressure and ratifying the ObamaCare status quo.
The bill is an imperfect compromise between moderate and conservative Republicans, and it makes pains to accommodate different interests and the Americans, states and businesses that have adapted to ObamaCare over the years. The center-right nature of the details means the Senate won’t be ushering in some free-market utopia. But the reform is a major improvement over the U.S. health-care status quo that will worsen if the bill fails.
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Senate aides expect that Majority Leader Mitch McConnell (R., Ky.) will bring the health bill as soon as Tuesday, shortly after the Congressional Budget Office has scored the bill. Both chambers have to pass the exact same bill, and there are a few ways for that to happen. The quickest option would be for the House to take up and vote on the Senate bill, but it’s not yet clear if there is enough support in the House to pass it. If they did, it would go straight to the White House. The House could also tweak the Senate bill and send it back to the Senate, which would have to vote on the modified bill. Or GOP leaders in both chambers could put together a group tasked with forging a compromise between the House and Senate bills. The new compromise bill would then have to be approved by both the House and Senate.
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Highlighting the continued uncertainty around the Affordable Care Act marketplaces, insurers announced major changes to their offerings for next year, including pullbacks that potentially leave more counties without exchange plans.
Anthem Inc. said it will exit the marketplaces in Wisconsin and Indiana next year, while nonprofit MDwise said it too would leave the Indiana exchange. Those moves may leave four Indiana counties at risk of having no exchange insurers in 2018, according to the Kaiser Family Foundation, though its researchers cautioned the outlook remains unclear. An estimated 44 counties in Ohio, Washington and Missouri will likely face a similar situation.
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nsurance startup Oscar Insurance Corp. said it plans to expand its offerings in the Affordable Care Act marketplaces, as insurers face a federal deadline Wednesday for initial filings to participate in the health law’s exchanges next year.
Oscar, which has been under a spotlight partly because of its tie to the Trump administration, said it aims to begin selling ACA plans in Tennessee for the first time in 2018, and re-enter the exchange in New Jersey, where it sat out this year. The insurer also will expand the regions where it sells ACA plans in California and Texas, and will continue selling plans in its home market of New York. Last week, Oscar announced that it will begin selling marketplace plans in Ohio next year, working with the Cleveland Clinic.
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Rep. Greg Walden of Oregon, who helped shepherd the party’s health-care overhaul bill through the House last month, sat down with Louise Radnofsky, The Wall Street Journal’s White House reporter, to offer his take on where the repeal and replace effort stands.
“The House has passed the American Health Care Act to try to do reforms, to get cost control on the Medicaid system, give states more flexibility to design plans that will work for them and move people into an insurance product they can afford. We know there’s more work to be done. We believe we gave the Senate some nice headroom and some dollars set aside in there to make other changes. So they’ve got some flexibility. We’ll see where this leads. But I think we’ll get a bill to the president’s desk before August.”
A growing number of major insurers are seeking premium increases averaging 20% or more for next year on plans sold under the Affordable Care Act, according to rate proposals in more than 10 states that provide the broadest picture so far of the strains on the marketplaces.
As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals from a few states that risk leaving some consumers with no exchange plans next year. But the rate requests by major insurers show stress on the marketplaces stretches beyond those trouble spots.
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