Friday, September 8, 2017

Hickenlooper-Kasich, Crazy Enough to Work?

Gov. John Hickenlooper advocated a bipartisan revision to the nation's health insurance program during a U.S. Senate hearing Thursday.
"Many people are angry, and they have a right to be," the Democratic governor testified.
He developed the plan with six governors from both parties as the time to revise the Obama administration's Affordable Care Act is running out this year.
A Senate budget resolution that Republicans have been using to authorize repeal of Obamacare expires at the end of this month.
Meanwhile, insurance companies hit with huge claims are dramatically increasing premiums or closing their business in some states.
Virginia and Tennessee could lose all of their health insurers in little more than a year unless Congress intervenes to change the Affordable Care Act, senators said at the hearing.
In Colorado, 14 counties are served by only one health insurer since other companies dropped out, Hickenlooper said. Some families pay as much as a quarter of their income to comply with the Affordable Care Act's requirement to be insured, known as the individual mandate.
"Our Division of Insurance is projecting premiums will increase by as much as 27 percent in 2018," Hickenlooper said. "It's a big problem."
So far, all efforts by Republicans to change the Affordable Care Act have failed, leaving a bipartisan plan like the one proposed by Hickenlooper as one of the few alternatives.
The Senate Health, Education, Labor and Pensions Committee scheduled four hearings in a week as it tries to salvage a new health insurance program.
Hickenlooper suggested keeping the unpopular requirement that individuals must buy the insurance if employers don't offer it, at least until Congress develops a better replacement.
Another provision of the plan he spearheaded with Republican Gov. John Kasich of Ohio calls on the Trump administration to fund cost-sharing reduction payments to insurers.
The plan also says Congress should fund a reinsurance program to cover care for the sickest patients, thereby eliminating their heavy costs from everyone else's premiums.
"So many of these [insurance] pools tend to be dominated by the least healthy people," Hickenlooper said.
He said he knew of a few patients whose health care costs exceeded $5 million a year.
"That raises premiums for everyone," Hickenlooper said.
He wants Congress to give states more flexibility to craft their own solutions to health care costs, rather than forcing them to comply with one federal standard.
"Existing regulations limit our ability to come up with creative solutions," Hickenlooper said.
One of the most successful state programs mentioned during a Senate hearing Wednesday was Alaska's reinsurance program.
The state invoked Section 1332 of the Affordable Care Act to authorize shifting federal funds to state programs that bring down insurance premium prices. Alaska shifted coverage for patients whose cases are the costliest to a separate pool that the state funds through a reinsurance program.
Premiums for all other insured persons fell 7 percent afterward.
The bipartisan plan Hickenlooper proposes draws from the Alaska example.
Colorado's primary innovation is its Accountable Care Cooperative, Hickenlooper said.
The cooperative gives residents an option to join a system that emphasizes preventive health care, such as immunizations, health screenings and weight management.
"In Colorado, we're trying to stretch federal dollars and pinch pennies," Hickenlooper said. "It's time for the federal government to work with us, not against us."
U.S. Sen. Michael Bennet, D-Colo., said other industrialized countries pay half as much as the United States on health insurance but still provide their people with good care.
"We're getting worse results," Bennet said.
U.S. Sen. Cory Gardner, R-Colo., issued a statement before the hearing Thursday, urging cooperation in Congress to resolve skyrocketing health-care costs.
"Our current health-care system will continue to fail Coloradans if we don't do something to address the rising costs created by the Affordable Care Act," Gardner said. "This should not be OK."
Hickenlooper was joined at the speakers table Thursday by Republican Govs. Charlie Baker of Massachusetts, Bill Haslam of Tennessee and Gary Herbert of Utah, along with Democratic Gov. Steve Bullock of Montana.
A group of Colorado Senate Republicans "mailed in" questions to Hickenlooper about his "nominally bipartisan" proposal.
The governor "didn't bother to discuss his supposedly-bipartisan plan with Colorado Republicans," Senate President Kevin Grantham said in a statement, "so we thought we'd give this a shot."
The questions addressed the growth of Medicaid, rising premiums and a lack of details in Hickenlooper's proposal.
"The governors' plan offers no specific recommendation for modifying the onerous burdens in current law placed on small employer plans," the Colorado Republicans wrote. "Does Governor Hickenlooper, as a former small business employer, have any personal thoughts or recommendations on that important issue?"
Grantham questioned labeling Hickenlooper's plan "bipartisan" when only two of the nation's 34 Republican governors signed on.
"If we're going to come up with a Colorado solution to these issues, in a truly bipartisan way, Colorado Republicans should have a place at the table that they haven't had so far," Grantham wrote.

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