A provision in Obamacare that gives states some power to change portions of the law needs to become more flexible to lower healthcare costs, a top Republican told the Trump administration Friday.
In a letter sent to Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma, Sen. Lamar Alexander, R-Tenn., urged the administration to make changes to a program known as “innovation waivers.” The waivers allow states to make certain changes such as setting up a reinsurance fund that pays for the medical costs of sicker enrollees.
Alexander specifically asked the administration to rescind its guidance for the waivers so that states can design their plans more freely, to approve the waivers faster and to allow states that are replicating others to be approved even more swiftly. He also suggested that the Obamacare waivers and Medicaid waivers, which operate similarly, be allowed to be submitted together so that crossovers and savings can be shown together.
Alexander, who is chairman of the Health, Education, Labor and Pensions Committee, did not cite examples of state waivers that have been submitted. Some states have asked for certain customers to move from Medicaid to Obamacare plans, but those proposals are in limbo and experts say such a move would necessitate a change in federal law by Congress.
States have said the waiver process involves excessive paperwork, is expensive, inflexible and takes a long time. It can involve top officials from the administration, as well as state officials and governors. What is allowed can vary depending on the party and priorities of an administration.
“I have tried to fix this problem in Congress. Unfortunately, not a single Democrat would work with us to repeal and replace Obamacare,” Alexander wrote. “When efforts to repeal the law stalled, I tried for seven months to find a short-term, bipartisan solution to help Americans trapped in the Obamacare marketplaces … I worked on a bipartisan proposal that included new permanent flexibility for the State Innovation Waivers, and funding that would have lowered premiums by up to 40 percent. But the Democrats in Congress blocked the proposal. They refuse to change a single word of the broken law.”
Republicans and Democrats had arrived at a legislative solution that would have given states more flexibility. Ultimately, the bill did not pass because Democrats objected to language in the bill that would have prohibited funds from paying for health insurance that offered abortions.
If the legislation had passed, premium costs were expected to drop for certain Obamacare customers who are now facing higher costs in the years ahead.
