Blue-state lead­ers work to pre­serve as­pects of Oba­macare

New York gov­er­nor fi­nal­izes man­dates

The Washington Times Daily - - POLITICS - BY TOM HOW­ELL JR.

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.”

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