EDITORIAL: Ohio solves its exchange problem — at least for now

Akron Beacon Journal (OH)

Aug. 28--Applaud the Ohio Department of Insurance. Jillian Froment, the director, and her colleagues mobilized to solve the problem of 20 mostly rural counties without an insurer participating in the health insurance exchange. That void put more than 11,000 Ohioans at risk of lacking needed health coverage.

A month ago, the department announced that insurers had been found for 19 counties. On Thursday, Paulding County, the last remaining county without a plan, gained coverage, too, CareSource agreeing to fill the gap, just as it has helped elsewhere.

What began in June with the larger insurers Anthem and Premier Health withdrawing from most counties has reached a happier ending. That also goes for the country, every county now with at least one insurer for its marketplace exchange in 2018.

For its part, the state insurance department performed as a good regulator should. It worked with the industry to address the shortage without losing sight of the larger public interest. The Affordable Care Act can succeed as long as stakeholders join to work through the shortcomings in what basically is a sound structure.

Jillian Froment is right about another thing. This is a temporary solution. The collapse of Republican efforts to repeal the Affordable Care Act brings a small measure of certainty. Insurers know they can raise monthly premiums, and the subsidies available will absorb the blow to most customers.

It helps that President Trump has not followed through on threats to end key payments that assist low-income customers with deductibles and other out-of-pocket costs.

Now Congress must act, and quickly. Fortunately, U.S. Sen. Lamar Alexander, a Tennessee Republican, appears determined to make a try at bipartisan legislation to strengthen the capacity of the exchanges to offer accessible and affordable coverage.

Alexander has the calendar in mind, September a crucial month as insurers face deadlines to finalize plans for next year.

The exchanges operate for those who buy health insurance on their own. That is a small share of the total market, around 20 million people compared to 150 million with employer-based coverage and 75 million with Medicaid. The Affordable Care Act actually has meant overall improvement to an individual market troubled for decades, notably, in failing many who are chronically ill.

Look around the country, and states from Idaho to Arizona, Michigan to Massachusetts, feature multiple insurers selling to individual buyers. Ideally, every county would have at least two insurers. How to get there?

Something must be done to enhance the individual mandate, and the subsidies must be more realistic, many still unable to afford decent coverage. Most important, Congress and the White House would do well to adopt the spirit of Jillian Froment and colleagues: Commit to solve the problem.

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