Alexander: Health care fix for 2018

Alexander: Health care fix for 2018

September 13th, 2017 by Lamar Alexander in Opinion Columns

Tennessee's senior United State senator, Lamar Alexander, wants to craft a small, bipartisan solution to help fix the individual insurance market for 2018.

Photo by Robin Rudd /Times Free Press.

Last week, Gov. Bill Haslam and Tennessee's insurance commissioner, Julie McPeak, came to Washington to testify before the Senate health committee — which I chair — to help us take a small step to help solve a problem that's causing a lot of grief for 350,000 Tennesseans.

These Tennesseans are in the individual insurance market. Nationwide, 18 million get their insurance in that market, rather than from an employer or from Medicare or Medicaid. It is only 6 percent of the people who have health insurance in America, but each one is important. These are farmers in Pulaski, songwriters in Nashville, small business owners in Sevierville — and right now, they are facing the very real prospect of skyrocketing insurance premiums in 2018 or even having zero options for health insurance next year.

I invited Gov. Haslam and Commissioner McPeak to give their insight and expertise at our committee's hearings [last] week — the first two of four hearings we'll hold — to come up with a small, bipartisan, balanced solution for those individuals to help limit their premium increases for next year, and to help ensure they have some choices of insurance in 2018.

Commissioner McPeak has described Tennessee's individual market as "very near collapse." At the end of September last year, BlueCross, our largest insurer, pulled out of the individual market in Knoxville, Nashville and Memphis, not just for Tennesseans with Affordable Care Act subsidies — for everybody.

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That could happen again at the end of the month — if Congress doesn't act. But if Congress acts this month, we can help limit those increases in premiums in 2018; continue support for co-pays and deductibles for many low-income Tennesseans; make certain that health insurance is available in every market; and lay the groundwork for future premium decreases.

We can do this by taking just two actions: amending the section 1332 waiver already in current law so Tennessee and other states can have more flexibility to devise ways to provide more choices of insurance and lower costs, and second, appropriate cost-sharing payments through the end of 2018 to help with copays and deductibles for many low-income Tennesseans, which also has the effect of lowering premiums generally.

There are a number of issues with the American health care system, but if your house is on fire, you want to put out the fire. In this case, the fire is in the individual market. While I am disappointed the Senate failed to repeal and replace the Affordable Care Act in July, I'm committed to taking a small, first step to find a short-term solution for stabilizing Tennesseans' premiums and helping to ensure they have some choice of insurer next year.

Working together during the last two years, our committee has been able to agree on big steps on big issues about which we have big differences of opinion. In education, we fixed No Child Left Behind, a step the Wall Street Journal called "the largest devolution of federal control to states in a quarter century"; we passed 21st Century Cures, which has the potential to help nearly every Tennessean live a healthier life; and we passed the first overhaul of mental health laws in a decade to help the one out of every five adults in Tennessee who struggles with mental illness. So we should be able to take this small step.

Health insurance has been a very partisan topic for a very long time, but the bottom line today is that 18 million Americans — including 350,000 Tennesseans — need our help, and I hope senators can work together — as we have in the past — and stay focused on getting a result.

Republican Lamar Alexander is Tennessee's senior U.S. senator.

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