Call it redemption or just call it a second chance. After spending the entire year debating one idea after another to dismantle our health care system — an effort that finally hit a wall just a few short weeks ago — Congress will have the opportunity to find common ground to stabilize and actually improve our nation’s health insurance markets.
Maine Sen. Susan Collins deserves credit for this opportunity for showing the courage to speak up and point out that the Senate had lost its way and was about to do more harm than good.
At Consumers for Affordable Health Care, we know what’s at stake. Every year, we help thousands of Mainers navigate our health system. We know all too well that, while so many Maine families have benefited, it is not a perfect system. But we also know there are actions Congress can take right away to limit, and even begin to repair, the damage that they have already done.
First, Congress must move quickly to approve funding for cost-sharing reductions. These are federal reimbursements to insurance companies to minimize out-of-pocket costs, such as deductibles and copayments, for many lower-income consumers who get their insurance through the Affordable Care Act marketplaces. This includes more than half of marketplace consumers in Maine. Without these payments, insurance rates will skyrocket next year as insurers are forced to cover those costs with higher premiums.
Cost-sharing reductions are a classic “pay now or pay a lot more later” decision for Congress because those same premium increases will ultimately be paid by the federal government in the form of tax credits. The Congressional Budget Office estimates that if Congress doesn’t fund the cost-sharing reductions, it will leave the federal government on the hook to spend an extra $4 billion next year alone, in part from use of tax credits to offset higher premiums. This seems like an easy one: Congress should do the right thing, fund the cost-sharing reductions, and save the government $4 billion.
Second, the Trump administration seems eager to sabotage the Affordable Care Act. Last week, for instance, they slashed outreach advertising by 90 percent and pulled the rug out from under community groups across the country that help consumers with impartial enrollment help, cutting funding for “health insurance navigators” by more than 40 percent. This certainly does not help consumers, who count on getting expert advice when they’re making decisions about their health and finances. Congress should put a stop to this interference by funding and enforcing marketplace education and promotion, so all Americans know what their options are.
Third, Congress should consider extending some of the Affordable Care Act’s “premium stabilization programs,” such as reinsurance. Reinsurance is a way of keeping premiums down by protecting health markets against extremely high claims costs. Reinsurance programs in other states have helped keep premiums down — even those who may not qualify for tax credits or subsidies. Congress should look at ways to make sure every state can benefit.
Fourth, Congress must fully abandon any remaining effort to cut funding for Medicaid. Medicaid and Medicare are the foundation of our health care system. Here in Maine, Medicaid is the insurer that pays for about 4 out of 10 births. Medicaid provides health insurance for half the kids in our state. Medicaid is Maine’s biggest insurer of long-term care costs. Jeopardizing the safety of our kids, older Mainers and our most vulnerable by playing a shell game with Medicaid funding should be a red flag for anybody who wants to keep Maine healthy.
Finally, let’s not forget that it was only a few short years ago that you could be denied coverage for a pre-existing condition, charged more if you were sick or have your benefits cut off if you hit an annual or lifetime cap. Nobody comes out ahead when insurance companies are allowed to cut and run as soon as they need to hold up their end of the bargain. Congress must protect these essential benefits and fair rules from here on out.
Margaret Chase Smith, in her famous Declaration of Conscience, said “too much harm has already been done with irresponsible words of bitterness and selfish political opportunism.” We see that same dynamic at play today, but Congress has a second chance. They can join the work Collins and Sen. Angus King have already been doing for months and seek ways to stabilize the markets and make the system work better for everyone — consumers, doctors, hospitals and insurance companies. We hope Congress is ready to do the right thing and move America forward.
Steve Butterfield is the policy director at Consumers for Affordable Health Care, a nonpartisan nonprofit organization that advocates the right to quality, affordable coverage for every person in Maine. Their Consumer Assistance HelpLine can be reached at 1-800-965-7476.