I feel like patients and their providers have been repeatedly put through the wringer, with a political promise on one side, sweeping and disruptive policy changes on the other, and people's lives in the middle.
With each successive push to repeal and replace the Affordable Care Act, hospitals, doctors, nurses, nursing homes, and others have been working together to carefully assess the potential impact on consumers and patients. After the stalling of Congress' third big attempt — in just nine months — to repeal and replace, 27 Pennsylvania health care groups are breathing a temporary sigh of relief.
But, more importantly, as we once again pick ourselves up from the latest fire drill, these groups agree on some specific, short-term, practical, somewhat bipartisan actions that Congress can take right now — some this very week — to put Pennsylvania's health care on more solid footing.
1. Keep Pennsylvania kids covered: Invest in CHIP by September 30
Protecting the health of our children — all of our children — is one of the best investments we can make in our collective future.
Right now, in Pennsylvania, we are succeeding with that investment. Because of CHIP (the Children's Health Insurance Program) and Medicaid, 95 percent of our children have health insurance. That includes children in families and households that have low incomes, or where the breadwinner(s) don't get health insurance through their jobs. Let's keep it that way. Congress should reauthorize funding for CHIP immediately, before it expires on September 30.
2. Shore up the marketplace in the short term: Pay insurers for cost-sharing subsidies — or expect rate increases to double
Rushing to vote on sweeping proposals to repeal and replace Obamacare because it is driving up premiums and deductibles, is both a bit of an exaggeration (at least here in Pennsylvania), as well as a case of the tail wagging the dog.
What's also clear is that these mischaracterizations, coupled with big, hastily conceived changes, run the risk of becoming self-fulfilling prophecies.
According to this week's testimony from Pennsylvania's Acting Secretary of the Department of Human Services (and former Insurance Commissioner), Teresa Miller:
However, Pennsylvania's insurance rates have yet to be finalized. They assume a continuation of the "current federal regulatory structure" — in other words, the continuation of the Affordable Care Act.
Insurers are saying that, in order to stabilize the individual market in the short term, we should protect the Affordable Care Act's individual mandate and honor its cost-sharing reduction provisions.
Without cost sharing, insurance rates could go up an average of more than 20 percent. Without either cost sharing or the mandate, rates could go up an average of more than 35 percent.
3. Protect vulnerable communities: Extend payments that help community clinics, rural hospitals, and hospitals that serve vulnerable communities
Authorization for several provider payments and other funding that supports Pennsylvania's most vulnerable communities is about to expire. Congress should immediately reauthorize funding for: