The issue:

With lack of action in Congress, the health insurance market continues to fluctuate, with
costs in Colorado expected to increase 27 percent in the individual market this year and 7.5 percent in the small group market.

What we think:

It’s time Congress took a look at three governors’ proposals to address uncertainty
in the marketplace and to keep costs down.

Tell us what you think:

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When the Affordable Care Act passed, the stated goals were more health coverage for more people at lower prices.

It hasn’t exactly worked out that way — and that’s not only because the original law was flawed. It’s also because Congress has chipped away at the ACA until only parts of it remain. First, Congress delayed the medical device tax, which was supposed to help cover the increased health insurance costs for lower-income people who receive government subsidies for health insurance. Next, it repealed the mandate that everyone have insurance in the tax bill.

And finally, the president has chipped away at the law’s foundation by repeatedly saying that the ACA was destabilizing the insurance industry.

That uncertainty led state insurance regulators to forecast a 27-percent increase in health insurance premiums in 2018. And that’s on top of the 20-percent increase insurers passed along to consumers in 2017. Double-digit increases in insurance were supposed to end with the Affordable Care Act. Instead, the cost of health insurance is growing so quickly, small and medium-sized businesses aren’t able to keep up.

Enter Colorado Gov. John Hickenlooper, a Democrat; Ohio Gov. John Kasich, a Republican; and Alaska Gov. Bill Walker, an Independent. The three haven’t given up on a bipartisan blueprint for health care.

Their plan, they say, includes discounts that reduce health insurance premiums, lower costs to keep younger, healthier people on insurance plans and a Medicaid overhaul tailored to individual state needs. And, they say, it’s important to encourage quality care, instead of focusing on the amount of care, number of tests and number of visits.

The plan also calls for the return of the individual mandate, a $15 billion state reinsurance fund to help cover the most expensive costs for critically ill patients and federal assistance for rural counties that have limited access to health insurance carriers. It also calls for the return of federal subsidies to assist in paying premiums.

It’s an echo of Hickenlooper and Kasich’s proposal from last year: Maximize carrier and consumer participation, promote enrollment, stabilize risk pools and reduce costs through innovation and designing new plans to meet today’s needs.

It seems simple — but it probably won’t fly in today’s hyper-political Congress. It keeps the bones of the ACA in place, including the federal subsidies and two-for-one Medicaid match for poor state residents.

Hickenlooper and Kasich favor the notion that Medicaid recipients should work. And while Walker expanded Medicaid in Alaska in 2015, there is momentum behind a work requirement in his state. Kasich and Hickenlooper had said, however, that only a small number of people receiving Medicaid are both able to work and unemployed.

The ACA is flawed, and so is the Hickenlooper/Kasich/Walker plan. For instance, it doesn’t have savings or cost estimates attached; it doesn’t say how to fund some of the more expensive items, like the $15 billion reinsurance program.

But change has to start somewhere. It’s time Congress got on board with laws that will aid micro- and small businesses while maintaining high quality, humane care. n CSBJ