Joanne Kenen from Politico, Paige Winfield Cunningham from The Washington Post, and Margot Sanger-Katz from The New York Times dive into the current health policy landscape. They discuss Congress's ongoing attempts to repeal and replace the Affordable Care Act and the critical upcoming open enrollment. The group also examines the political tensions regarding health care legislation, the implications of new Medicaid funding proposals, and the emerging challenges in navigating health insurance complexities. Plus, they highlight the urgency surrounding the opioid crisis and the need for effective solutions.
The proposed Graham-Cassidy plan could lead to reduced insurance coverage for low-income Americans by consolidating Medicaid funding and restricting state resources.
The upcoming open enrollment period for individual health insurance is significantly shorter, raising concerns about accessibility and enrollment awareness among potential beneficiaries.
Deep dives
Republican Repeal and Replace Proposal
A proposal put forth by Senators Graham, Cassidy, and Heller seeks to provide more control to states by consolidating marketplace subsidies and Medicaid funding into a lump sum. This drastic change would particularly disadvantage states that expanded Medicaid, as they would receive a steadily decreasing share of the funds until they face a complete cut-off in 2027. While the proponents argue it fosters state-level innovation, critics highlight that it could result in reduced insurance coverage for low-income Americans, as states may not utilize the funds for direct health insurance coverage. The complexity of the reforms raises concerns about whether states have the capacity to manage broader administrative functions previously overseen by federal agencies.
Uncertainty Surrounding Open Enrollment
The upcoming open enrollment period for individual health insurance for 2018 is poised to be significantly shorter and marked by uncertainty regarding navigators and advertisements. The enrollment window is reduced to six weeks, leading to concerns that many potential enrollees might miss out on signing up. Additionally, a lack of clarity regarding funding for outreach programs raises alarm about the support available for those unfamiliar with the process, as many beneficiaries rely on navigators to assist them. Given the political messaging that undermines the stability of marketplace options, it is feared that many individuals may not recognize their need to enroll or be unaware of their opportunities.
Challenges with Marketplace Stability
Despite the perception of an imminent collapse of the Affordable Care Act (ACA), recent evidence indicates some counties previously without insurers are beginning to stabilize, contradicting alarming claims about the law's viability. Rates for plans are expected to increase significantly, influenced by various factors including the uncertainty of cost-sharing subsidies, which raises costs for those not receiving federal assistance. Importantly, messaging from the current administration is widely viewed as detrimental, as it fails to provide information on the benefits of enrollment and instead emphasizes failure. Advocacy efforts may not match the previous scale seen during the Obama administration, complicating efforts to bolster enrollment numbers.
Congress's Legislative Agenda and CHIP
As September approaches, Congress faces urgent legislative tasks, with only 12 working days to address key issues such as appropriations, the Children's Health Insurance Program (CHIP), and the debt ceiling. Bipartisan cooperation will be essential, especially concerning CHIP, which has typically received support across party lines, though related negotiations may be contentious. Additionally, discussions around funding for cost-sharing reductions could leverage CHIP to stimulate bipartisan collaboration, but uncertainties remain regarding the duration and extent of that funding. The interplay between healthcare reform, budget deadlines, and party dynamics during this period may shape the future of health policy in the U.S.
Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Paige Winfield Cunningham of The Washington Post and Margot Sanger-Katz of The New York Times discuss the continuing efforts in Congress to “repeal and replace” the Affordable Care Act, upcoming open enrollment for individual insurance and Congress’ long health care to-do list for September.
