Gov. Bill Haslam appeals to Congress: Confront skyrocketing health care costs
Michael CollinsWASHINGTON – Gov. Bill Haslam called on Congress on Thursday to move quickly to stabilize the individual health insurance market and then embark on “a serious effort” to deal with skyrocketing health care costs.
“All of us – Republicans, Democrats and independents – should agree that our current path is not a sustainable one,” Haslam told a Senate panel.
A lot has been said and written about the immorality of having millions of Americans lose health insurance coverage, and “I understand the argument,” Haslam said.
“However,” he added, “can’t we all acknowledge that it is just as morally questionable to cover everyone with health insurance and put the bill on a credit card to be paid by our grandchildren and not do everything we can to make health care affordable?”
Haslam’s testimony before the Senate Health, Education, Labor and Pensions Committee came during the second of four bipartisan hearings aimed at finding a short-term fix to stabilize the individual insurance market after the collapse of GOP efforts to repeal and replace the Affordable Care Act.
The committee’s chairman, Sen. Lamar Alexander, R-Tenn., said he hopes senators can forge a bipartisan agreement by the end of next week and pass legislation by the end of the month to keep prices down and make it possible for everyone in the individual market to be able to afford insurance.
Congress must act quickly. New insurance rates for 2018 must be posted on the government’s website, healthcare.gov., by Sept. 27.
More:Tennessee’s insurance chief returns to the DC spotlight, health care is only a piece of the job
At Thursday’s hearing, the committee heard from Haslam, a Republican, and four other governors: Republicans Charlie Baker of Massachusetts and Gary Herbert of Utah and Democrats Steve Bullock of Montana and John Hickenlooper of Colorado.
A key issue that has emerged during the debate over how to stabilize the individual market has been the future of cost-sharing payments the government makes to insurers to help them provide coverage for low- and moderate-income families.
President Donald Trump has threatened to end the payments, worth about $7 billion this year.
But top insurance regulators from five states, including Tennessee Insurance Commissioner Julie Mix McPeak, told the committee on Wednesday that cost-sharing must continue to help stabilize the market. McPeak called the payments “the single, most critical issue” to stabilizing the market.
In their testimony Thursday, all five governors also urged Congress to continue the payments.
About 60 percent of all Tennesseans who buy their insurance on the federal marketplace created under the Affordable Care Act receive subsidies to help lower premiums, Haslam said.
Failure to continue the cost-sharing funding would lead to significant premium increases and create more uncertainty in the market, Haslam said.
More:Tennessee's ACA market 'even less secure' after failed repeal, insurance chief frets
Congress can take additional steps to stabilize the market, Haslam said, by funding a short-term reinsurance program that would limit losses to carriers that provide coverage in the marketplace. And, he said, the federal government should allow states more flexibility to design insurance plans more suitable to their own needs.
Hickenlooper said the federal government has been undermining state efforts to bring down premiums.
“It’s time for the federal government to work with us, not against us,” he said. “Without your help, it’s like climbing one of Colorado’s famous 14,000-foot mountains in winter without crampons. It can’t be done.”
Once the individual market is stabilized, Haslam said, Congress should turn its attention to out-of-control health care costs, which he said are crippling businesses and families and overwhelming state and federal budgets.
Tennessee already has taken some steps to control spending by changing the way it pays for health care services. In the initiative, which began with TennCare, the state’s Medicaid program, providers are compensated based upon the value of the coverage they provide, not the volume.
Early results show the state is saving millions of dollars while maintaining quality of care, Haslam said.
Haslam suggested the federal government consider a similar model to help control costs.
Herbert said the federal government should give states the primary responsibility for regulating their health insurance markets. He also suggested creating a transition period so that markets can make necessary adjustments with less subsidization and taxation.
Two more hearings are planned next week. The committee will hear Tuesday from various health policy experts. Health care providers and other stakeholders, including Nashville surgeon Manny Sethi, will appear before the panel next Thursday.