Bipartisan Group of Governors Release ACA Health Reform Plan

A group of eight United States governors released a comprehensive plan for stabilizing the ACA through congressional reform in an open letter to the Majority and Minority leaders of both congressional houses. 

The group includes Republican governors: John Kasich of Ohio and Brian Sandoval of Nevada; Democratic Governors: John Hickenlooper of Colorado, Tom Wolfe of Pennsylvania, Terence McAuliffe of Virginia, John Bel Edwards of Louisiana, and Steve Bullock of Montana; and an Independent: Bill Walker of Alaska. 

“We ask you to take immediate steps to make coverage more stable and affordable,” the governors wrote. “The current to be fixed. Governors have already made restoring stability and affordability in this market a priority, and we look forward to partnering with you in this effort.”

Their plan called for immediate steps congress should take to stabilize the ACA markets for 2018, including funding cost-sharing reduction subsidies for insurance companies for 2018—and end the uncertainty surrounding subsidy payments by appropriating funding through 2019. Other recommendations included creating a stability fund for reinsurance programs, incentivize offering competitive plans in counties with limited options, and continuing the individual mandate until Congress can stabilize the market. 

“The current mandate is unpopular, but for the time being it is perhaps the most important incentive for healthy people to enroll in coverage,” the governors wrote. “Until Congress comes up with a better solution—or states request waivers to implement a workable alternative—the individual mandate is necessary to keep markets stable in the short term.”

Longer-term recommendations included actions to maintain coverage gains and keep costs down. The governors recommend federal efforts to encourage participation in the ACA in order to keep the health insurance pool full of young and healthy Americans who will offset costs for the sicker patients. This plan also includes reforming current law to allow families who cant afford employer-sponsored plans to receive tax credits for ACA plans. 

Interestingly, the reform plan called for Congress to grant States the power to redesign the essential health benefits. These benefits are the list of coverage options that are required in order for an insurance plan to meet the minimum standard under the ACA. 

“HHS should give states that develop alternatives to essential health benefits that meet the requirements of Section 1332 of the ACA the opportunity to pursue and implement innovative approaches,” they wrote.

Additionally, the group of governors called for Congress to support innovation through granting Medicaid program waivers. However, the plan emphasized that states should not be allowed to waive community rating requirements, prohibitions on preexisting condition exclusions, lifetime maximum coverage limits, preventive care mandates, or coverage for adults as dependents through age 26. 

“We strongly encourage that Congress and the Administration take immediate action to stabilize the [ACA]” the governors concluded. “The real challenge over time will be to confront the underlying cost drivers of health care spending.”

—David Costill