After the GOP failed in its initial efforts to repeal and replace the Affordable Care Act, several bipartisan proposals to fix the current law are gaining steam.
Colorado Gov. John Hickenlooper, a Democrat, and Ohio Gov. John Kasich, a Republican, tell Colorado Public Radio that their staff collectively are working on a joint plan to stabilize the country's health insurance markets, to be released ahead of September hearings in the U.S. Senate.
They also intend to get other governors from both parties to sign onto the plan, to show support at the state level.
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"I'm not going to get into specifics with you until we have it all ironed out, but it's not going to be some pie-in-the-sky, way up there kind of stuff," Kasich says. "There will be things that we will address that will have specific solutions. And one of the things we're finding out is the states do have some power to do some things unique to them, as long as these insurance markets are going to be stabilized."
Two specific ideas the governors talk about: raising the workforce threshold for the employer mandate so that smaller companies won't be deterred from hiring, and offering publicly-funded reinsurance to help the sickest people.
"The probably top one on our list would be this notion of having some sort of reinsurance to make sure the high-cost pool is not causing higher rates for all the people seeking insurance on the private markets," Hickenlooper says. "You use reinsurance in almost every type of insurance program to cut off those 'hill tops' as we say."
Meanwhile, a 43-member bipartisan group in the House calling themselves the Problem Solvers Caucus is moving forward with another proposal to fix the ACA, according to The Fiscal Times.
Some of the specifics include guaranteeing the federal government's cost-sharing reduction payments to insurers; raising the threshold of the employer mandate from 50 employees to 500; re-defining the "full-time" workweek from 30 hours to 40 hours; creating a federal stability fund to reduce the premiums for high-cost patients; encouraging states to experiment with ways to save money; eliminating the 3.2 percent tax on medical devices, while keeping the law's added taxes on high earners.
Robert Pozen of the Brookings Institution writes in Health Affairs Blog that the Problem Solvers' ideas are "short-term and sensible."
Pozen then offers additional proposals that he views "as consistent" with group's goals: preventing abuses of the enrollment process; providing health care coverage in "bare" counties; encouraging higher participation by young adults; coordinating exchange policies with health savings account requirements; restructuring the Cadillac Tax for high-cost plans; and abolishing the Independent Payment Advisory Board.
Pozen ends his post by stating that the Problem Solvers' ideas are "a doable bipartisan path forward" that should be "modestly" expanded.
"Although most Republicans and Democrats would prefer much broader reforms, this bipartisan package would substantially improve the current health care system in sensible ways," he writes.
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
