Deemed the “Obamacare bailouts,” the cost-sharing reductions and reinsurance payments were not included in the House version of the government funding bill that is to be voted on before the Friday night deadline. Cost-sharing reductions, a reimbursement to insurers for providing discounts to low-income enrollees, and reinsurance, a subsidy to cover the costs of some especially sick enrollees, were floated as a way for the government to help lower premiums, which are set to rise again this year.
Unfortunately, the problems with rising healthcare costs don’t stop there. Even if the government were to bailout insurance companies this year, the underlying problems continue to worsen. The 2018 midterm elections will be pivotal to determine the direction of the next two years of President Trump’s first term and reform healthcare, in some form or fashion, is constantly at the top of people’s priority list. The message to Congress is simple: don’t forget about Obamacare.
Healthcare costs are expected to stay on their upward trajectory over the next decade, while continuing to outpace economic growth. The Department of Health and Human Services (HHS) estimates that by 2026, healthcare spending will be almost one-fifth of the U.S. economy for the first time ever. That same report shows that a few drivers for the constant cost increases are the aging population, rising cost of care, and ballooning prescription drug prices.
Without Congress’s help, some states are trying to take it into their own hands. In January of this year, Idaho, administrators refused to comply with the healthcare law, by attempting to provide Idahoans with cheaper options that fail to meet the regulatory criteria listed in Obamacare. Their goal was to encourage younger, healthy individuals to buy insurance plans. Then, earlier this month, HHS sent a letter stating that the executive order did not meet the law’s standards and forcing them to uphold current federal law. States like Hawaii and Alaska have obtained waivers to direct existing federal funds in a more effective way, but the difficulty and length of the process has forced other states to withdraw their requests. If states cannot act on their own to address these problems, it’s on Congress to find permanent fixes.
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Leading the charge inside the beltway, former Sen. Rick Santorum is continuing to work on legislation similar to the Graham-Cassidy bill, which was narrowly defeated last fall. The Graham-Cassidy bill turned over much of the federal healthcare system to the states through block grants, enabling the states to be able to design systems that work well for them, in the hope that the result would be lower prices. Some notable changes to that bill could be expanding Health Savings Accounts and giving individuals with state-government run plans the flexibility to purchase insurance in the private market.
Republican Sen. John Barrasso (R-WY) has also introduced legislation to make an executive proposal that was issued by the Trump administration permanent. The Improving Choices in Health Care Coverage Act would grant individuals the ability to stay on less expensive, short-term insurance plans for up to 364 days. It would also permit them to renew these plans every year. They include fewer services than traditional plans covered by Obamacare, making them a cheaper alternative for individuals who may otherwise forgo buying health insurance. In April 2016, President Obama limited the amount of time people could stay on these plans to no more than 90 days, in order to incentivize people to participate in the Obamacare exchanges. This bill would codify into law the change made by the Trump administration, giving people the ability to stay on these plans for a year, with the ability to renew, instead of for three months.
Other options that have been floated by the White House include reforming how digital healthcare data is shared and lowering drug prices. The CREATES Act is a bipartisan piece of legislation that would lower drug prices for the government, insurance companies, and consumers by billions of dollars over the next decade. None of these solutions are the golden ticket to fixing the long list of problems with Obamacare, but are a few of the numerous ideas that can move the needle in the right direction. Healthcare continues to be on people's minds and simply leaving it in its current state is simply unsustainable.
It’s clear that there are solutions out there, but the hard part will be how to implement them in such a hyper-partisan environment. Obamacare is not a forgotten issue, in fact, many members that are again running for reelection this fall have campaigned for almost a decade on repealing the healthcare law. Repeal and replace may be an optimistic ask, but someone must at least consider solutions that address issues Americans have with their healthcare. A promise to fix the broken healthcare system is what elected a lot of members to Congress over the years, they shouldn’t break their promise again in 2018.
Jake Grant is the Outreach Director for the Coalition to Reduce Spending and an Advocate for Young Voices. The views expressed are his own and do not necessarily represent the views of the Coalition to Reduce Spending. Follow him on Twitter @thejakegrant
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