Blue-state leaders work to preserve aspects of Obamacare
New York governor finalizes mandates
New York Gov. Andrew Cuomo moved Monday to require insurers in his state to stick with broad-coverage mandates, hoping to lock in Obamacare’s gains for his residents even as Republicans are trying to repeal the law in Washington.
Mr. Cuomo, a Democrat, also finalized rules mandating commercial health policies to cover contraceptives at no additional cost to female enrollees, hoping to push back against President Trump, who is considering letting companies opt out of the birth control mandate if they have religious or moral objections.
“We will not stand idly by as ultra conservatives in Washington try to roll back the progress we have made to expand access quality, affordable health care, putting our most vulnerable New Yorkers at risk,” the governor said.
Mr. Cuomo is among several blue-state leaders who are working to preserve aspects of Obamacare now, citing the threat of repeal.
State lawmakers in Connecticut are considering legislation that would codify Obamacare’s insurance benefits for women and children, while Rhode Island Democrats want to preserve the law’s “essential benefits” and bar lifetime limits on coverage of those benefits.
The Hawaiian legislature already sent a bill to its governor that would preserve much of Obamacare in their state, including the essential benefits and the individual mandate requiring people to hold insurance.
In essence, they are doing what the GOP itself has called for — allowing the states to forge their own path on health care — so their moves amount to a rebuke of the Republican vision for health care, or a preemptive bulwark against any resulting plan that forces states to roll back Obamacare.
Yet Mr. Cuomo also moved to thwart more immediate problems stemming from the 2010 law itself, and Mr. Trump’s handling of the law. The new president has threatened to withhold reimbursement money for insurers who pick up low-income customers’ costs.
Mr. Cuomo said any plan that withdraws from the state-run insurance exchange will be barred from participating in Medicaid or otherwise contracting with the state.
“These aggressive actions will make certain that no matter what happens in Congress,” he said, “the people of New York will not have to worry about losing access to the quality medical care they need and deserve.”
Analysts said competition is more of a problem in other states, which could follow the Empire State’s lead and tether their contracts to exchange participation.
Republicans say dwindling choice in the marketplace is a key reason they need to uproot Obamacare.
The U.S. House has already passed an Obamacare replacement that would let states waive the part of the Affordable Care Act requiring insurers to cover a list of 10 “essential” benefits that include things like maternity care, substance abuse treatment and prescription drugs.
Insurers could also decide to charge healthier people lower premiums, so long as they subsidize the costs of sicker people whose costs would rise.
The bill has moved to the Senate, where some Republicans are wary of the waivers.
The Senate says it is drafting its own health care bill instead of simply adopting the House bill, which is projected to leave 23 million more Americans without insurance a decade from now.
Younger and healthier people could pay far less than they do now in states that waive rules on insurers, although sicker people might be priced out of the market in those states.
Analysts said blue states that choose to retain Obamacare’s protections will still face difficult trade-offs unless the Senate softens deep cuts to taxpayer assistance in the House bill, dubbed the American Health Care Act.
“If passed, the AHCA would unleash debates in 50 state capitals about how to balance affordability, benefits, and protections for people with pre-existing conditions,” said Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation. “One big challenge facing states is that the AHCA pulls about a trillion dollars in federal funding out of the health system, so states would be making difficult trade-offs with smaller subsidies for private insurance and fewer resources for Medicaid.”