Senators’ health fix deserves support

Tennessee Sens. Lamar Alexander and Bob Corker reached into their firstaid kit to patch a wound in the Affordable Care Act and, for lack of something more substantial, pulled out the Health Care Options Act of 2017.

The legislative Band-Aid is for people who live in counties where health insurance providers have bailed out of the health care exchanges established under the ACA.

It would allow them to use their ACA subsidy to purchase any health insurance plan outside of the exchanges as long as the insurance is approved by the state.

In counties where the Secretary of Health and Human Services certifies there are no options on an ACA exchange, the legislation also would waive the act’s requirement to buy a specific health care plan or pay a fine.

The bill would sunset in 2019, but it has merit as a temporary fix to the ACA, which remains the law of the land in the wake of the Republican-led Congress’s failure to repeal and replace the Obama administration’s signature legislative achievement.

Something had to be done, the senators figured, when Humana, the Knoxville area’s one remaining ACA insurer, pulled out of the exchange for 2018 and fears the same thing could happen elsewhere in Tennessee continued to grow.

“There is also a real prospect that all 230,000 Tennesseans who buy insurance on the exchange—approximately 195,000 with a subsidy—won’t have any plans to buy next year either,” Alexander said, “and millions of Americans in other states are facing the same dire circumstances.”

Of course, a lot heavier lifting will be required to, in Corker’s words, “resolve the issues that are driving up health care costs, limiting choices, and causing the exchange market to spiral downward.”

It’s still not clear what Congress will come up with as a replacement for the ACA, which has made access to health care insurance available for roughly 20 million Americans and, in Tennessee, lowered the percentage of the uninsured to a record level, even without Medicaid expansion in the state.

The gains face a new threat in the form of a lawsuit brought by Republicans in the U.S. House challenging the use of cost sharing reductions, which subsidize out-of-pocket costs, including deductibles, for people who make 100250 percent of the federal poverty line.

With so much uncertainty about the future of the exchange, luring companies such as BlueCross BlueShield of Tennessee or Cigna back into uncovered areas will be challenging, said Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance, in an interview with the USA TODAY NETWORK – Tennessee.

Some clarity could come in June, when insurers are required to notify the state Department of Commerce and Insurance if they intend to sell in 2018 and new rates are set. More defections by insurers could lead to a 2018 spike in the uninsured ranks, unless officials find a way to ensure profitability.

Meanwhile, Alexander and Corker deserve support for their temporary fix. When a Band-Aid is all one has, it doesn’t pay to sit and hope for a better remedy.