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Republicans take critical first step to protect health insurance coverage for millions

After a couple of false starts, Republicans in the U.S. House passed a bill to follow through on their promise to repeal and replace Obamacare.

Getting this bill passed was a critical first step in saving health coverage for the millions of Americans who are experiencing the collapse of the individual health insurance market under the weight of Obamacare’s regulations.

Several state insurance markets are in the throes of a death spiral—a situation where a market implodes after cycles of rising premiums prompt healthy people to abandon the market, leaving behind an unsustainably sick and expensive pool.

The benchmark plan the Kaiser Family Foundation uses to compare premiums across states shows eighteen states experienced double-digit premium increases in the past year.  Since 2014, fifteen states experienced a 50 percent or higher increase and five states posted a jump exceeding 100 percent.  Markets cannot sustain this level of premium increases.

In the last day, news surfaced of even more trouble stirring in state insurance markets.  Aetna announced it will no longer serve the Virginia market.  Already, people living in 1 in 3 counties in America have only one insurer available.   Aetna’s departure from Virginia could add another 27 counties to this list.

Going down to one insurer is bad enough, but several counties in Iowa may have no insurance options in 2018.  Last month Aetna and Wellmark Blue Cross & Blue Shield announced they would pull out of the market in 2018 and Medica just threatened to follow suit.  The Des Moines Register reports that “the carriers’ exit could leave more than 70,000 Iowans who buy their own coverage without any options for 2018.”

The rise in premiums and the decline in choice across so many state individual insurance markets in 2017 represents a watershed moment.  Many of these markets now look nothing like they did before Obamacare, which goes to show Obamacare isn’t just failing, it’s failed.  Republicans have no choice but to fix it.

Unfortunately, the next leg of the road to getting a good bill to President Trump’s desk looks even bumpier than this first.  The Senate has a much thinner majority and includes four members who have already published a letter stating they “will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”

While the House dealt with divisions between moderates and conservatives over how to protect people with pre-existing conditions, the letter from the four senators suggests the Senate will now need to address divisions over how to cover low-income households.

Though the road ahead will be difficult, Republicans do seem to be catching on to the urgency and the necessity of getting a good bill passed.  With each new announcement of an insurer abandoning a state market, the road to repeal and replace should get smoother.

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