UPDATE: Remember, friends, that we don’t have to guess at what might happen if the “individual mandate” is not preserved. In the mid-1990s, the state of Washington implemented many healthcare policy changes now favored by many Republicans, and the result was a complete collapse of the insurance market in the state. This now-classic Seattle Times story from January tells the tale in detail:
By 1999, it was impossible to buy an individual policy in Washington. Every insurer had pulled out. Premera Blue Cross said it lost more than $120 million in Washington before it stopped selling individual policies.
With no requirement to buy insurance — and the guarantee that people could buy insurance if they got sick — healthy people could hold off, only signing up if they needed medical care.
A sicker population of people buying insurance pushed premiums up. Which, in turn, led more healthy people to hold off. Which pushed premiums up…[Pols emphasis]
…“The whole principle of insurance is you buy it before you need it,” a health adviser to then-Gov. Gary Locke said in 1999, just before the last two insurers left the state. “You can’t buy fire insurance when your house is burning down.
Denver7’s Blair Miller reports on the announcement yesterday by Govs. John Hickenlooper of Colorado and John Kasich of Ohio of a new plan to stabilize health care markets and protect essential components of the 2010 Affordable Care Act–a plan gaining wide approval from policy experts and politicians from the left to the center-right of the political spectrum:
For starters, Hickenlooper and the governors advise that Congress retain the individual mandate under the Affordable Care Act, which requires people to have insurance through their employer or the ACA lest they face a penalty, “until it can devise a credible replacement.”
The governors admit the mandate it “unpopular,” but say it’s “perhaps the most important incentive” for market stabilization because it encourages healthy people to buy insurance and not gamble on whether or not they will need coverage each year…
“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,” the governors wrote.
The other immediate step the panel asks for is to have Congress and the White House commit to funding the cost-sharing reduction payments through at least 2019—pointing out that the National Association of Insurance Commissioners, National Governors Association, and U.S. Chamber of Commerce have all said doing so is “an urgent necessity.”
As of this writing, most mainstream Colorado Republicans are expressing cautious optimism about the plan, though they say they haven’t read the details to comment on specifics. Rep. Mike Coffman and Sen. Cory Gardner both said as much, praising the bipartisanship and “looking forward to learning more.”
Coffman agrees with the governors’ on one point, “I think we owe it to the American people to stabilize the market. It’s the worst part of health care in terms of rising rates.”
Coffman’s admission that the political instability affecting health insurance markets is a problem is significant, and we’ll be watching to see it echoed by others. But for the state’s right-wing ideological pole star, Americans for Prosperity, the “KasichlooperCare” plan is a nonstarter:
— Jesse Mallory (@jessemallory) August 31, 2017
That’s Jesse Mallory, former state Senate GOP staffer-turned Americans for Prosperity-Colorado’s executive director. That’s the kind of obstinance we’ve all become used to in local GOP politics, and reflects the head-meets-wall approach by Republicans in Washington D.C. this year as they tried and failed repeatedly to pass legislation to repeal the Affordable Care Act. Before the GOP’s political will to repeal Obamacare collapsed in a heap, this kind of obstinance made political sense.
Today, if Republicans want to demonstrate an ability to functionally govern ahead of the 2018 elections–something it would really behoove them to do if they want to reduce expected heavy midterm losses–they need to ignore guys like Jesse Mallory. This plan is not a statement of principles, it’s a small-scale responsible step to stabilize the status quo after a political failure that Republicans need to acknowledge. And move on from.
“Kasichlooper” is pointing the way, if they have the wisdom to see it.