Hope for bipartisan cooperation on health care reform hinges on key provisions, UMass Medical School expert says

May 08, 2017

There may be grounds yet for some key bipartisan cooperation on health care reform even amid the fierce debate in Washington, DC over the hot button issue, says UMass Medical School health policy expert Robert W. Seifert, MPA.

As the debate over repealing and replacing the Affordable Care Act (ACA) moves to the Senate, Seifert says there are potential changes to Obamacare that members of both parties could probably line up behind.

The House last week passed the American Health Care Act (AHCA) which, among other things, would end the expansion of Medicaid starting in 2020 while giving states the power to opt out of certain requirements, such as guaranteeing insurance for those with pre-existing conditions.

“A market-based solution or something that acknowledges that the ACA, the basis of the ACA is a market, is an insurance market, would be attractive really to both sides of the aisle,” says Seifert, principal of the Center for Health Law and Economics at UMass Medical School.

Seifert’s comments come as the Senate gears up to make its own changes to the ACA that by political necessity will have to be palatable to Democrats in the closely divided chamber.

Key Senate members have signaled they will use the recently passed House bill, which repeals key parts of the ACA, as a starting point for building their own legislation.

In particular, stabilizing the insurance market and expanding the insurance risk pool are ideas Seifert says could get backing from both Republicans and Democrats.

“Certainly removing the uncertainty in the insurance markets would be helpful,” Seifert says. “I think there is interest in both sides in doing that.”

In fact, a couple key Republican senators have already signaled they plan to push for significant changes in the House’s proposed overhaul/revamp of Obamacare.

In the House bill, current insurance subsidies provided under the ACA based on income and insurance costs in particular markets would be replaced with tax credits based on a person’s age,.

Sen. John Thune of South Dakota wants to keep some subsidies based on income and age, while Sen. Rob Portman of Ohio is looking for a smoother phase out of Medicaid expansion, according to Modern Healthcare.

A lot is at stake in the coming health care policy negotiations for the majority party in Congress and President Donald Trump, Seifert notes.

“There is a political promise at stake here … their pledge was to repeal and replace the ACA,” he says.

“If they can see a path towards changes in the ACA that have their stamp and they can point to as being successful health care reform, that might be attractive to the Republican side,” Seifert says.

In order to do so, though, Republicans in the Senate and House will have to find a way to compromise with Democrats “who are protecting tooth and nail the existence of the ACA.”

If a deal can be cut, though, “both sides can declare victory” and “millions of people don’t have to lose their health insurance on this,” Seifert says.

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