Time to Embrace Real Solutions to the ACA

While this was a monumental victory of preventing the ACA from being repealed recently should not be overlooked, the time to support the ACA is just beginning.  The Trump administration still has two weapons to use to hinder the survival and success of the ACA.  The first is the federal budget in which there will be attempts to undermine both Medicaid and the ACA.  The second is the actions of the Trump administration in general.  The key to defending the ACA is not only continued support, but also a bipartisan answer to some of the problems that the ACA faces.

While Republicans maintain that the ACA is failing, the facts refute that this is true.  The ACA has expanded health insurance coverage to over 20 million people and current healthcare spending is below historical trends.  That does not mean that the ACA is without flaw, but now that the fight to kill the ACA is over, the time has come for bipartisan support to improve the ACA.  In order for the ACA to continue its success, premiums need to be lowered and the market needs to be stabilized.  While in the past two years insurance markets have stabilized more and more, but there is still work to be done for 2018 and beyond.  Due to policy uncertainty and the constant threat of repeal, there has been recent deterioration of the markets as insurance companies realize there is a looming possibility of pulled funding.  It is this uncertainty that has hindered the ability of the ACA to complete the task it was commissioned to do.  There are bipartisan ways in which this uncertainty can be alleviated such as:

1. Offering a guarantee on the continued payment for ACA subsidies.  This would lower premiums without raising cost to the government.  This guarantee also removes the ability for the current administration to sabotage the ACA.
2. Following the lead of states such as Alaska and Maine that reimburse insurers for high-cost enrollees.  Both states, after implementing a reinsurance program, saw a drastic dip in their premiums.
3. Using incentives or other alternatives to encourage insurers to enter markets in rural areas or counties that are without marketplace plan options.  Senator Claire McCaskill proposes allowing such counties to access insurance through the Congressional health insurance plan DC Healthlink, and other options include exemptions from the health insurance tax to encourage insurers to enter these markets.
4. Lowering the cost of prescription drugs to help save taxpayer money on Medicaid costs.

The Wisconsin Alliance for Women’s Health predicts that with these changes, countless Americans would see coverage expanded, insurance markets would stabilize, and healthcare would be more affordable with lower premiums.  In other words, the ACA would finally be able to reach its full potential.  The problem is that the Trump administration has already begun to undermine the ACA after their failure to ensure its demise.  According to a Kaiser Family Foundation poll, 74% of the public think that the current administration should do what they can to make the current health care law work.  The legislature has also shown that it is willing to make the ACA work on both sides of the aisle, and a series of hearings aimed at crafting bipartisan legislation to strengthen the ACA have already begun.  What happens next in healthcare will rest greatly on the continued support of the ACA in the face of sabotage from a president that is set on limiting access to healthcare.  The key is to stay on our Senators to not cut Medicaid in the federal budget and put an emphasis on the stabilization of the current marketplace.