I was heartened by the bravery of Sens. John McCain (R-Ariz.), Rand Paul (R-Ky.) and, Monday, Susan Collins (R-Maine) to stop something that wasn’t going to fix anything, as their plans to vote 'no' on the Graham-Cassidy health reform legislation led Sen. Mitch McConnell (R-Ky.) on Tuesday to pull the bill from consideration.
The Affordable Care Act isn’t perfect — something that its authors and supporters, including President Barack Obama, acknowledged from the beginning. There are things that need to be fixed and protections to be honed and preserved. As advisers, we can look beyond politics to promote common sense solutions.
I’ve learned a lot over my life listening to people I disagree with, and often found myself surprised by the fact that there was more in common that I always see. Discussions around the ACA have further proven that. Here’s a simple punch list:
- Fix the individual markets, which have seen unsurprising huge price increases since 2014, as 50% of individuals are no longer getting denied coverage because of health conditions. And these increased rates have had little bottom-line impact for most consumers (since higher rates have translated into higher subsidies), but crushed the individuals and households above the 400% threshold.
- Restore reinsurance for individuals and small employers, continuing the reasonable protections these most delicate markets need to survive.
- Protect and encourage private market solutions and competition.
- Simplify reporting, full-time hour threshold, market availability for low-participation groups and similar rules that have become barriers rather than incentives for compliance.
Relentless political pressure
I bemoan the state of politics on both sides. Partisanship overwhelms common sense. After the failure of the Senate to pass something in July, I was hopeful as Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) — two people who don’t have perfectly aligned views on much — worked together to find a bipartisan fix for the ACA’s shortcomings. That effort was overtaken by the Graham-Cassidy bill push.
The ability for our political leaders to sit down and hash out a compromise seemed doomed by the relentless pressure everyone gets from the political extremes within the media and their political structures. It’s frankly frustrating for someone who has long believed in the idea that we can sit down, have good conversations and solve problems if we just try.
Sen. Alexander — a politician I’ve watched nearly my entire life as someone who grew up so close to Tennessee — shared something important a couple of weeks ago in the New York Times in an article about bipartisanship:
Mr. Alexander sees progress, and he recalled a bit of advice from Howard Baker, a former Senate Republican leader from Tennessee and a mentor to Mr. Alexander.
“Senator Baker used to say, the other fellow might be right,” he recounted. “We have kind of lost the capacity to understand that.”
We need to fix the healthcare system in a way that encourages stability — and allows politics to get the hell out of the way.
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