Scranton roundtable talk explores future of health insurance

March 28--After the GOP's failure to repeal and replace the Affordable Care Act last week, a panel of experts gathered in Scranton to discuss the future of American health care.

Geisinger Commonwealth School of Medicine hosted a roundtable discussion on the topic Monday, organized by the school's chapter of the American Medical Association Medical Student Section.

"The school is dedicated to care of the community and community engagement," said medical student and event organizer Nichole Ogojiaku. "We wanted to make sure ... that the community, and students here as well, know what's at stake."

House Speaker Paul Ryan acknowledged Friday that the Affordable Care Act, also known as Obamacare, would remain in place "for the foreseeable future" after House Republicans' failure to secure the 216 votes necessary to advance the American Health Care Act -- the GOP's long-promised ACA replacement -- to the Senate.

While Democrats celebrated the bill's failure as a political victory, many acknowledge that the 2010 health care law is imperfect. Citing examples of insurance providers pulling out of ACA exchanges and soaring personal premiums in some cases, lawmakers on the left and right have called for a bipartisan approach to health care reform.

Speaking to an audience of about three dozen, many of them medical students and doctors, the panel expressed a similar sentiment Monday.

"At the political level, at least, I think we might be at a good spot," said ACA marketplace navigator Tom McHugh, who works for the Advocacy Alliance. "I think we might be out of the spotlight, and I think we are going to sit down and say: 'The (ACA) isn't perfect, we don't have an alternative plan, so let's get together ... and talk about how we can strengthen what's already there.'"

This would require compromise from Democrats, Republicans and President Donald Trump, whose approach to health insurance reform moving forward will likely bear on the future of the industry.

"The choice the Trump administration is going to have to make is whether to let the exchanges explode or kind of take ownership and try to address the concerns," said Jeffrey Bechtel, senior vice president for health economics and policy at the Hospital and Healthsystem Association of Pennsylvania. "Will they promote enrollment next year in the exchanges to bring more young people in to help ... stabilize costs? Will they try to make tweaks to the market to get insurance companies to join the market and to participate?"

While the ACA survived the GOP's first repeal-and-replace effort during Trump's tenure, future health care decisions in Washington may open the door for new reforms.

The Medicare Access and CHIP Reauthorization Act of 2015, a Medicare reform package commonly known as "Doc Fix," for example, reauthorized the Children's Health Insurance Program for two years. That reauthorization expires this year, likely making the CHIP reauthorization process the next piece of health care legislation to move through Congress.

"The children's program is the first of the major components of the Affordable Care Act coming into an expiration," said Brian Ebersole, senior vice president of mission delivery at the Wright Center for Graduate Medical Education, who said the legislation "could be a vehicle to do some additional health care reform."

"I don't think we've heard the end of the (GOP's) AHCA," he said. "That CHIP reauthorization ... is actually attached to the Affordable Care Act, so when you start to amend that, that will actually link back into the (ACA) to start changing some of the provisions."

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jhorvath@timesshamrock.com

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