Ohio Gov. John Kasich on Friday said that some of the essential health benefits that had been set up under Obamacare were too limiting to customers, proposing that someone have the option to buy a plan that excludes maternity coverage while explaining his decision to mandate autism coverage in his state.
Kasich, a Republican, was appearing in a panel in Washington alongside Colorado Gov. John Hickenlooper, a Democrat with whom he has been working on an Obamacare stabilization plan to lower the costs of premiums and give customers more choices for health insurance plans.
Part of the flexibility that would be appropriate for states to have jurisdiction over, he said, would be to have more determination on what benefits health plans should cover. Under Obamacare, maternity coverage, hospital coverage, addiction treatment, and a range of other health benefits are mandated.
Kasich cited the example of a healthy 23-year-old patient, whom he said might want the opportunity to purchase coverage that excludes maternity care, in favor of a catastrophic plan that boosts health savings accounts.
"Why do you have to give them maternity coverage if they don't want it?" he asked in a discussion hosted by the conservative American Enterprise Institute and the liberal Center for American Progress.
"What I'm suggesting is you get choice," he said later during the panel. "But there has to be some sense of the core benefits."
He later pointed to his signature on a bill in Ohio that mandated private health insurance cover the screening, diagnosis, and treatment of autism spectrum disorder, saying he believed it was necessary.
Kasich was against the GOP plan in Congress to repeal and replace Obamacare, and vetoed a bill passed by the Ohio legislature that would have put a freeze on enrollment in Obamacare's Medicaid expansion.
"I want to have a marketplace where people can buy insurance," he said. "And if they can't afford it let's help them pay for it."At the panel he raised the possibility of allowing states in future years to move healthy people who make between 100 and 138 percent of the federal poverty level from Medicaid into private health insurance coverage. Such a move would require higher subsidies by the federal government.
"When you give states flexibility you also have to have guardrails," he said. "But it shouldn't be so strict that it prevents innovation."
Hickenlooper cited the individual mandate as another example where states could have more flexibility, as long as they have some other mechanism for encouraging young and healthy people to sign up for coverage. Under current law people who do not buy private coverage are fined.
"The waivers are a big pain in the neck," Hickenlooper said, later citing the example of how long they take to be approved by the federal government. Under the law, the administration must review the proposals for at least 180 days.
Kasich and Hickenlooper introduced a list of recommendations in August to fix Obamacare that involves payments of cost-sharing reduction subsidies to insurers as well as a reinsurance program, and testified before a Senate committee on Thursday. One of the main points of contention during Obamacare's debate has been over whether states should have more flexibility, with key Democrats saying they are unwilling to roll back essential health benefits.
Hickenlooper said that the committee hearing was more open and bipartisan that his other experiences in Washington have been."I feel optimistic that something could happen," Hickenlooper said.