Ohio Gov. John Kasich and Nevada Gov. Brian Sandoval urged congressional leaders on Wednesday to strengthen individual health insurance markets to ensure more affordable and stable coverage amid uncertainty over the future of the exchanges.
Republicans Kasich and Sandoval led a bipartisan letter signed by eight governors that was sent to Democratic and Republican leaders of the House and Senate. The governors are seeking immediate federal action to stabilize markets, efforts to preserve gains in coverage and to contain costs, and an active partnership between states and the federal government – areas they are confident can attract bipartisan support in Congress.
“Continuing uncertainty about the direction of federal policy is driving up premiums, eliminating competition and leaving consumers with fewer choices,” the letter stated.
Proposed premiums on some popular exchange plans are expected to increase 18 percent in 2018, the letter said, and 2.5 million residents in 1,400 counties will have only one carrier available to them on the exchange.
“Despite these headwinds, states continue to try to stabilize the individual market and have developed innovative solutions to preserve coverage while making insurance more affordable,” the letter said.
The governors called for a commitment to fund cost sharing reduction (CSR) payments from the Trump administration and Congress. Not making those payments would drive up premiums 20-25 percent and increase the federal deficit $194 billion over 10 years, the Congressional Budget Office estimates.
They also urged the creation of a temporary stability fund for states to create reinsurance programs or reduce premiums.
Furthermore, the governors recommended that Congress keep the individual mandate in place for now. “… To prevent a rapid exit of additional carriers from the marketplace, Congress should leave the individual mandate in place until it can devise a credible replacement,” the letter said.
“The current mandate is unpopular, but for the time being it is perhaps the most important incentive for healthy people to enroll in coverage. Until Congress comes up with a better solution — or states request waivers to implement a workable alternative — the individual mandate is necessary to keep markets stable in the short term.”
To preserve gains in insurance coverage and help contain costs, the governors also recommended federal lawmakers maximize market participation by encouraging and educating younger and healthier people to buy coverage to improve the risk pool, and to take further steps to stabilize risk pools.
The governors want to see active federal-state partnerships, as well. The first focus of that effort should be on improving the regulatory environment, increasing support for state innovation waivers and controlling costs through payment innovation, the letter said.