Since winning the
"This is a reasonable evolution of what should be discussed," said
Ginsburg was one of four panelists in a
The other panelists were
He said House Speaker
"I'm not sure how effective this would be," Ginsburg said. "Some might not be able to achieve it."
Lucia said people should expect lots of possible options to be floated in the next few months. These could include high-risk pools similar to what 35 states offered those with pre-existing conditions prior to the ACA going into effect.
"There's lots to learn from the states' experience," he said.
Dahill said that some states may abandon the health insurance marketplaces, or health insurance exchanges as they're often called, if federal subsidies dry up. Others may try to find a way to sustain them.
"It's hard to fathom the cutoff of 20 million [formerly] uninsured," he said. "There will have to be some give and take."
Under the ACA, states had the option of expanding
The federal government covered 100 percent of this cost for the first three years, and then trimmed it back to 90 percent. Now there's discussion about giving states block grants to cover their share of
"The real concern with these approaches is if the amount of the grants will keep up with medical expenses, or if this is a crude way of leaving it to the states," Claxton said.
Dahill said that if more of the burden is shifted to the states, the states will have to find better ways of managing their programs and will likely shift some of their risk to health care providers.
"You open up a whole new body of thought as to how you serve health needs," he said.
People who have employer-sponsored health insurance probably won't see much change no matter what happens, the panelists said.
The exception could be the so-called
"That's one of the few areas that everyone thought should change," Claxton said. "Some employers are already cutting back."
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