Don’t be in rush to fix Senate healthcare bill

Congress has worked hard to craft solutions to challenges being experienced in the healthcare marketplace. The fact is that in many states the individual insurance market needs to offer more health-plan options at lower cost, and the same holds true for Kansans. We need Congress to act now in a thoughtful and beneficial way.

Throughout this debate, Ascension and Via Christi Health have sought to be a voice for our patients and the communities we serve by calling on Congress to pass legislation that meets three simple principles: Preserve the safety net for those who are poor and vulnerable and continue the progress to assure access to affordable healthcare for all; strengthen and stabilize the individual market because a vibrant and sustainable individual and small group market is essential to a successful, equitable healthcare system; and provide sufficient resources to continue proactively to transform the financing for the delivery of care to one that is value-based rather than volume-based because that is the key to lowering healthcare costs over the long run.

Over the last several months, I have talked with members of Congress and their staffs to communicate these principles and to encourage them to craft legislation that achieves these principles. Unfortunately, the discussion draft of the Better Care Reconciliation Act of 2017 (BCRA) released by the Senate last Thursday falls short of achieving these important goals.

That said, I want to acknowledge the Senate for some things it did well in this discussion draft. The Senate tried to make sure that individuals with pre-existing conditions are not charged significantly more for health care coverage. The Senate also moves toward a fairer tax credit than the House for older Americans who must buy insurance on the individual market. Americans closer to retirement still will have to pay significantly more than they do now because of the change in age rating bands, but the Senate will be more generous than the House in the amount of the tax credits provided to older Americans. The Senate also proposed waiving an outdated Medicaid exclusion for inpatient treatment of those with addiction, which is sorely needed.

Unfortunately, BCRA fails to meet our fundamental reform goals for legislation because it would result in even deeper cuts to Medicaid than the House version and put the care for millions at risk. The bill would cap and cut Medicaid at a rate far below the actual cost growth, especially in the years after 2026. In fact, it is the biggest restructuring of the Medicaid program in 40 years, which would impact the very people who need care the most. According to our estimates, this bill will cut up to $1 billion from Kansas’ Medicaid program, KanCare, over the next 10 years and will likely force thousands of Kansans off of this essential health coverage.

The draft bill as written would also further destabilize the individual insurance market because it removes the incentive of continuous coverage that had been included in the House bill. States that have laws guaranteeing issue of insurance without at least a strong legal incentive for continuous coverage have seen losses of coverage and a severe deterioration in the insurance market that results in spiraling premiums. The Senate has identified significant problems in the individual market, but is prescribing the wrong solution to address them.

I urge the Senate to do three things in order to address the crucial issues facing healthcare while “doing no harm:”

▪ Go back to the drawing board to keep working to find viable solutions that focusing on the three principles above.

▪ Immediately pass a short-term bill to shore up the individual market and halt the spiraling costs and loss of coverage being experienced there.

▪ Sit down with your colleagues on each side of the aisle. Partisan efforts to pass legislation have been ineffective in solving the very real issues that face our healthcare system. Please work with each other to find consensus and lasting solutions.

The work of our elected officials can be difficult. However, the Senate needs to continue working to develop a viable short-term and long-term proposal that preserves coverage, strengthens and stabilizes the individual market and continues the transformation of healthcare delivery to improve quality and lower costs.

This story was originally published June 30, 2017 at 5:02 AM with the headline "Don’t be in rush to fix Senate healthcare bill."