The Senate Committee on Health, Education, Labor, and Pensions (HELP) kicked off their hearings on stabilizing the individual health insurance market on Wednesday. With the testimonials of 5 insurance commissioners, it collectively suggested that resolving the market’s challenges would require added state flexibility via 1332 Waivers and the continuation of CSR payments.
During yesterday’s hearing (Day 2), members of the Committee heard from 5 Governors; Governor Steve Bullok (D-Mont.), Governor Charlie Baker (R-Mass), Governor John Hickenlooper (D-Col), and Governor Gary Herbert (R-Utah):
Governor Haslam’s testimony emphasized the need for prompt action, eluding that the Senate must move quickly to stabilize the market and make a serious effort to address the cost of healthcare. Recalling insurance premiums’ hefty impact on Tennesseans, he acknowledged the limited options his state will have during the 2018 open enrollment period. According to his testimony, approximately 80% of the state’s counties will have only 1 insurance carrier to purchase insurance from. “We are on a path were the system fails,” he stated but acknowledged that it can be resolved by funding CSR payments, establishing a short-term reinsurance program, and providing flexibility to the states.
“Stabilizing the insurance market impacts all areas of coverage,” advocated Governor Bullok who emphasized the strain on employer-sponsored insurance in the state of Montana. Sharing a common theme on the need to address rising costs, the testimony acknowledged the need for the continuation of CSR payment funding. Explaining how financial assistance and cost sharing have and continue to play a large role in driving down the cost of healthcare.
Echoing earlier testimony, Governor Baker urged the Committee to consider a number of next steps. The first, continue CSR payments- a premiere topic among witnesses during the first two hearings. He also recommended that the approval process for 1332 waivers become more prompt, that Essential Health Benefits (EHB) and other forms of consumer protections continue, budget neutrality be promoted, and that states obtain added flexibility.
“The ACA has been in operation, in Colorado, for 7 years,” Governor Hickenlooper explained. There, the state has expanded Medicaid and established a state-run marketplace that assists more than 10% of its population. He stressed that “consumers are angry” due to the high cost of healthcare and how most are paying twice as much as they did in previous years. His recommendation: streamline the waiver approval process and enact budget neutrality. In doing so, he believes we will be in a better position as a nation to address the underlying issues in healthcare.
“I greatly appreciate the role states have in our healthcare system,” proclaimed Governor Herbert. Recommending that states should take on a grander responsibility to resolve their unique challenges, he suggested that states should have the ability of determining what works, and what does not. States will innovate to establish creative solutions “and we will improve.” Other recommendations emphasized the expedition of the 1332 waiver process, and the need for congress to provide immediate certainty through a transition process, funding CSR payments until 2018 or 2019, immediately modifying the cost of healthcare by reducing the tax placed on it, and introducing more flexibility on health savings accounts.
Prior to their testimony, Senator Alexander called for changes relating to Section 1332 waivers. He suggested that:
- the approval process be shortened;
- states be permitted to file “me too” applications based on submissions approved for other states;
- governors and insurance commissioners be allowed to apply for the waivers rather than requiring legislative action;
- states be provided planning funds; and
- the definition of budget neutrality be broadened to allow the combining of savings from Medicaid 1115 waivers with 1332 waiver savings.
Presently, the individual insurance market impacts more than 18 million consumers or nearly 6% of the population with health insurance. 26 states have begun the process for applying for 1332 waivers.
There are two more hearings scheduled; Advocates for State Flexibility on September 12, and Health Care Stakeholders on September 14. Each will be available for public viewing via a live feed. A recap of day 1’s HELP hearing is available here.
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