Bipartisan experts urge next steps on coverage plan
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.