Bi­par­ti­san ex­perts urge next steps on cov­er­age plan

The Washington Times Daily - - POLITICS - BY ALAN FRAM

A group of con­ser­va­tive and lib­eral health pol­icy ex­perts is press­ing the Trump ad­min­is­tra­tion and Congress to take steps to quickly shore up cov­er­age un­der the Obama health care law, an idea that’s been anath­ema to Pres­i­dent Trump and many con­gres­sional Repub­li­cans.

The plan, a copy of which was ob­tained by The As­so­ci­ated Press, in­cludes con­tin­u­ing fed­eral pay­ments to in­sur­ers that Mr. Trump has threat­ened to block. They also want Mr. Trump and law­mak­ers to find a way for peo­ple to buy cov­er­age in the hand­ful of coun­ties that may have no in­sur­ers next year in the fed­eral and state in­sur­ance ex­changes cre­ated by Pres­i­dent Barack Obama’s sig­na­ture statute.

In ad­di­tion, the an­a­lysts want the ad­min­is­tra­tion to con­tinue urg­ing peo­ple to sign up for poli­cies and help­ing them en­roll, ef­forts stressed un­der Mr. Obama and cred­ited with prompt­ing many to ac­quire cov­er­age. The Trump ad­min­is­tra­tion has sig­naled it might cur­tail those out­reach ef­forts, one of sev­eral steps it’s sug­gested it might take to un­der­mine the law.

It is un­clear whether the rec­om­men­da­tions will have much in­flu­ence on one of the most po­lit­i­cally po­lar­iz­ing is­sues in Wash­ing­ton. The im­pact might also be blunted be­cause the Se­nate’s jolt­ing July 28 de­feat of the GOP ef­fort to re­peal Mr. Obama’s law has left Repub­li­cans di­vided over whether to seek a bi­par­ti­san deal with Democrats.

Yet the ad­vice, from lead­ing pol­icy ad­vis­ers to politi­cians of both par­ties, un­der­scores that, pol­i­tics aside, there are steps re­spected voices from both sides agree could be taken to prop up a law that’s ex­panded cov­er­age to around 20 mil­lion Amer­i­cans.

The pa­per says the sug­ges­tions are aimed at sta­bi­liz­ing health care mar­kets “un­til a longer-term res­o­lu­tion can be achieved and, most im­por­tantly, to pro­tect cov­er­age and health care ac­cess for those re­ly­ing on them now.”

The ex­perts want law­mak­ers to re­tain some way of en­cour­ag­ing healthy peo­ple to en­roll for health cov­er­age and pe­nal­iz­ing them if they don’t. The pur­chase of poli­cies by healthy con­sumers helps keep in­sur­ance mar­kets afloat be­cause they are gen­er­ally less costly to cover and help pay for cov­er­age of sicker cus­tomers, whose care can be ex­tremely costly.

Mr. Obama’s in­di­vid­ual man­date — which as­sesses tax penal­ties on those who don’t buy cov­er­age — is re­viled by Repub­li­cans. GOP bills passed by the House and pro­posed by Se­nate Repub­li­can lead­ers would abol­ish those penal­ties.

But in their place, the House mea­sure would have as­sessed higher pre­mi­ums on many peo­ple who have been un­cov­ered for more than two months. The re­jected Se­nate plan would have im­posed a six-month wait­ing pe­riod on peo­ple buy­ing poli­cies who had been unin­sured for over two months.

The an­a­lysts also pro­posed giv­ing the fed­eral gov­ern­ment and states flex­i­bil­ity to de­sign pro­grams. They sug­gested that states be al­lowed to com­bine money from the Med­i­caid health in­sur­ance pro­gram for the poor with fed­eral tax sub­si­dies and other pro­grams to “cre­ate seam­less cov­er­age ar­range­ments.”

In one sign of the dif­fi­cul­ties of the health care is­sue, the state­ment ac­knowl­edged that the an­a­lysts dif­fered over “the guardrails that should be es­tab­lished,” a ref­er­ence to the lim­its that might be placed on such new pro­grams.

The pol­icy ex­perts mak­ing the rec­om­men­da­tions in­clude Gail Wilen­sky, a Repub­li­can economist and former Medi­care direc­tor, and John McDonough, who was a se­nior ad­viser to the late Sen. Ed­ward M. Kennedy dur­ing pas­sage of Mr. Obama’s law.

The ex­perts com­posed the plan as a project of the Con­ver­gence Cen­ter for Pol­icy Res­o­lu­tion, a bi­par­ti­san non­profit group that looks for so­lu­tions to di­vi­sive is­sues. The cen­ter is sched­uled to re­lease the pro­pos­als Wed­nes­day.

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