WASHINGTON — A group of conservative and liberal health policy experts is pressing the Trump administration and Congress to take steps to quickly shore up coverage under the Obama health care law, an idea that’s been anathema to President Donald Trump and many congressional Republicans.
The plan, a copy of which was obtained by The Associated Press, includes continuing federal payments to insurers Trump has threatened to block. It says Trump and lawmakers should find a way for people to buy coverage in the handful of counties that may have no insurers next year in the federal and state insurance exchanges created by President Barack Obama’s statute.
In addition, the analysts want the administration to continue urging people to sign up for policies and helping them enroll, which was stressed under Obama. The Trump administration has signaled it might curtail those outreach programs, one of several steps it’s suggested it might take that would undermine the law.
It is unclear whether the recommendations will have much influence on one of the most politically polarizing issues in Washington. The impact might also be blunted because the Senate’s jolting July 28 defeat of the GOP effort to repeal Obama’s law has left Republicans divided over whether to seek a bipartisan deal with Democrats.
Yet the advice, from leading policy advisers to politicians of both parties, underscores that politics aside, there are steps respected voices from each side agrees could be taken to prop up a law that’s expanded coverage to around 20 million Americans. The experts urge action by Sept. 30, the end of the government’s budget year.
One signee, Lanhee Chen, policy director for Mitt Romney’s 2012 GOP presidential campaign, said that besides risking people losing coverage, “There’s also just a very real political price I think to be paid if Republicans allow the system to crash and burn.”
Ron Pollack, former director of Families USA, a main proponent of Obama’s 2010 law, said the suggestions would “lend encouragement to those that are already inclined to work on a bipartisan basis.”
Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have said they’ll try writing legislation to temporarily continue the payments to insurers and ease some of the Obama law’s requirements.
The paper says the suggestions are aimed at stabilizing health care markets “until a longer-term resolution can be achieved and, most importantly, to protect coverage and health care access.”
The experts want lawmakers to retain some way of prodding healthy people to enroll for health coverage and penalizing them if they don’t. The purchase of policies by healthy consumers helps insurers because they are less costly to cover than sicker, more expensive customers.
GOP bills passed by the House and proposed by Senate leaders would abolish Obama’s individual mandate, which assesses tax penalties on those who don’t buy coverage. Instead, the Republican measures impose higher premiums or long waiting periods for many who were uninsured previously.
The analysts proposed giving the federal government and states more flexibility for programs and a “judicious expansion” of tax-favored health savings accounts.
Trump has threatened to halt federal payments to insurers used to reduce out-of-pocket costs for around 7 million low- and middle-income people. Obama’s law obliges insurers to lower their costs and requires the government to reimburse the companies. A federal court temporarily blocked the payments, but Obama and Trump have continued them.
Others making the recommendations include Gail Wilensky, a Republican economist and former Medicare director, and John McDonough, a senior adviser to the late Sen. Edward Kennedy during passage of Obama’s law.
The experts composed the plan as a project of the Convergence Center for Policy Resolution, a bipartisan nonprofit group that looks for solutions to divisive issues.
AP reporter Ricardo Alonso-Zaldivar contributed to this report.