Trump should back bipartisan plan to stabilize insurance markets

Once again individuals without insurance will soon have the opportunity to purchase health insurance on the exchange managed by Access Health CT, but this year’s “open enrollment” period coincides with great uncertainty about a program that has vastly increased access to health coverage.

Since the enactment of the Affordable Care Act in 2010, the uninsured rate among the non-elderly population has dropped nationally from 18.2 percent to 10.3 percent, according to the Kaiser Family Foundation. That rate would have been driven lower had more Republican-controlled states agreed to participate in the expansion of Medicaid insurance coverage.

In Connecticut, which embraced health reform, the percentage of uninsured sits at about 3.5, among the lowest in the nation. About 96,000 state residents utilize private health care obtained on the exchanges, many others found coverage through the expansion of Medicaid.

Yet the nation has moved in a different direction, electing a president and placing a Republican Party in control of Congress with an agenda to repeal and replace the ACA. So far the Republicans have failed in those efforts, though President Trump continues to do what he can without legislative authority to undermine the law.

The president slashed federal allocations to market the health care exchanges from $100 million to $10 million, while shortening the enrollment period, and most recently blocking the subsidies to insurance companies that allowed them to charge affordable premiums to the near-poor who do not qualify for Medicaid and must purchase private insurance.

Despite this antagonistic environment, the Access Health CT program has managed to keep two competing private insurance firms on its exchange, down from a peak of four but better than some jurisdictions that have one or none. But to keep Anthem and ConnectiCare on the exchange, state insurance regulators have allowed them to substantially boost premiums, which could push the cost out of the reach of hundreds of individuals.

Open enrollment runs from Nov. 1 through Dec. 22 to sign up for coverage that begins Jan. 1. Despite uncertainty about the future of the ACA, individuals without insurance should explore their options on the exchange by visiting www.accesshealthct.com.

In the meantime, a rare bipartisan plan has surfaced in the U.S. Senate that would stabilize the insurance markets and keep coverage available to millions while the debate over how to amend or replace the ACA continues.

Negotiated by Sen. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., it would reinstate for two years the subsidies to insurers blocked by the president in his recent executive order. These subsidies allow companies to lower deductibles and co-pays and are critical to providing affordable coverage to individuals whose incomes are low, but not low enough to qualify for Medicaid.

In return, Republicans get something they want, the ability of insurers in the exchanges to provide a wider of variety of coverage options, some with much lower premiums, by way of waivers to the ACA current requirements.

In particular, the bill would allow the sale of catastrophic insurance plans, which have very high deductibles and demand large out-of-pocket payments by patients, but in return charge low monthly premiums while providing coverage for major medical problems due to illness or accident.

After showing initial interest, Trump has expressed concern about the legislation being a windfall for insurance companies. He should listen to Sen. Alexander, a conservative, about the bills “strong language” mandating that the subsidies pass through to benefit consumers, not the insurers.

To help Americans keep and maintain insurance, Trump should get behind the plan. His support is critical to passage, particularly in the recalcitrant House. This won’t fix health care in America, but it will buy time to do so.

 

 

 

The editorial board is composed of the publisher and four journalists of varied editing and reporting backgrounds. The board's discussions and information gained from its meetings with political, civic, and business leaders drive the institutional voice of The Day, as expressed in its editorials. The editorial department operates separately from the newsroom.

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