WORLD FUTURE FUND
SEPTEMBER 2017: A TIME OF DECISION
FOR AMERICAN HEALTH CARE
A MATTER OF LIFE AND DEATH
The Republican Party tried to destroy the Affordable Care Act (ACA), taking health insurance away from millions of people and killing over 200,000 people over 10 years. See our report Sick Republican 2017 Health "Care" Plan
This evil and insane action was stopped. But we are not out of danger.
President Donald Trump is threatening the stability of the health care market. He says that he'll end important subsidies for poor people who need health care. And given that insurers have only one more month to form their plans about marketplace participation, this isn't good. (Health Affairs, 2017)
Insurers must finalize a plan about their market place participation by September 27th. And yet insurers' willingness to participate in the marketplace faces tremendous uncertainty.
We call on Congress to form a bipartisan effort to protect the future of the American health care system.
Here are some ideas of key priorities going forward.
These are necessary measures for now but ultimately we need single payer, universal health care, like every other modern state.
See our report:
Donald Trump must not fulfill his threat to end subsidies for the poor:
The threats of President Donald Trump to end some of the subsidies paid to the insurance companies under the ACA have threatened the stability of the insurance marketplace. If Donald Trump fulfills his threats, premiums will rise by 20 percent and the federal budget deficits would increase by $194 billion (New York Times).
The subsidies Donald Trump has threatened to end are subsidies that reduce deductibles, co-payments and other out-of-pocket costs that low-income people pay when they visit doctors, fill prescriptions or receive care in hospitals. Even before efforts to repeal the ACA collapsed, President Trump began threatening to stop paying these subsidies. He said the health care law would “implode” and Democrats would have no choice but to negotiate a replacement plan. President Trump described his strategy as, “Let Obamacare implode, then deal.”
Should the President of the United States of America hold the health of the American people hostage in order to achieve his political goals? We think not.
Serious efforts must also be made to destroy the Bill Cassidy and Lindsey Graham plan to destroy the ACA:
Senators Bill Cassidy and Lindsey Graham are reportedly working with the White House to push their plan to repeal and replace the ACA. The Cassidy-Graham plan (which Senator Dean Heller has also co-sponsored) would have much the same damaging consequences as other Senate and House Republican repeal and replace bills. It would cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, increase out-of-pocket costs for individual market consumers, and weaken or eliminate protections for people with pre-existing conditions. (CBPP)
WHAT SHOULD CONGRESS DO?
Congress must permanently fund cost-sharing reductions:
As soon as possible, Congress must pass legislation that ensures that cost-sharing reductions (CSRs) will be permanently funded through a mandatory appropriation, eliminating any uncertainty raised by pending litigation. Insurers need political assurances that they will be reimbursed for this program, which will lower out-of-pocket costs for lower-income people in the marketplace.
Congress must extend and fund the ACA’s premium stabilization programs:
Congress must permanently extend the ACA's transitional reinsurance program, which ended in 2016, and appropriate funding for this program for at least 2018 and 2019. Over the long-term, this program should be funded as provided under the ACA, through assessments on health insurers across all markets.
Increase funding for outreach and enrollment:
Going into the 2018 open enrollment period (November 1st - December 15th) Congress must ensure that there is adequate funding for outreach and enrollment activities, including in-person enrollment assistance. There are challenges here, including public confusion about the status of the law and coverage options, as well as an open enrollment period that is only half as long as it was in previous years. Congress should guarantee that enrollment and outreach activities from the Department of Health and Human Services (HHS) will receive the same amount of funding as it did in previous years.
Build a long-term agenda to strengthen the marketplace:
It is critical that Congress focus its energies on a bipartisan reform package that addresses the short-term threats facing the marketplace. In the long-term, Congress should continue the bipartisan efforts to build on coverage gains made under the ACA law, instead of trying to dismantle the law. Long-term policies should break down barriers to coverage for the remaining uninsured (a number that is currently around 30 million), they should focus on improving the enrollment process, and improving affordability of coverage and care for all.
Three Things Congress Must Do Now to Protect Marketplaces and Consumers (Families USA, 8-22-17)
Trump Threat to Obamacare Would Send Premiums and Deficits Higher (New York Times, 8-15-17)
Trump doesn’t need Congress to overhaul Medicaid (Vox, 8-8-17)
The Deadline for Insurers To Decide On 2018 Marketplace Participation (Health Affairs, 2-17-18)
The Effects of Terminating Payments for Cost-Sharing Reductions (CBO, August 2017)
Drivers of 2015 Health Insurance Premium Change (Actuary, June 2014)
In-person Assistance Maximizes Enrollment Success (Enroll America)