Wrap up – Senate health committee hearing on stabilizing the individual market: state insurance commissioners

The Senate's health committee today held the first of four hearings this month on steps Congress could take to stabilize premiums in the individual insurance market so that the 18 million Americans in the market will be able to buy insurance at affordable prices in the year 2018.

Today, five state insurance commissioners testified - Commissioner Julie Mix McPeak, Tennessee; Commissioner Mike Kreidler, Washington State; Commissioner Teresa Miller, Pennsylvania; Director Lori K. Wing-Heier, Alaska; and Commissioner John Doak, Oklahoma. The committee will meet tomorrow to hear from five governors on stabilizing the individual health insurance market.

During his opening remarks at today's hearing, Chairman Alexander said: "This hearing is about taking one small step. A small step on a big issue which was been locked in a partisan stalemate for seven years - health insurance. This step is not so small to 18 million Americans--songwriters, the self-employed, farmers--those who do not get their health insurance from the government or on the job....To get a result, Democrats will have to agree to something - more flexibility for states - that some may be reluctant to support. And Republicans will have to agree to something - additional funding through the Affordable Care Act - that some may be reluctant to support. Health insurance has been a very partisan topic for a very long time, but the bottom line is that 18 million Americans need our help. I hope we can stay focused on getting a result."

Alexander has said, "Any solution that Congress passes for a 2018 stabilization package will have to be small, bipartisan and balanced. It should give states more flexibility in approving insurance policies by improving section 1332 of the Affordable Care Act as well as fund the cost-sharing reduction payments to help stabilize premiums for 2018."

All five state insurance commissioners at today's hearing agreed flexibility, in addition to the cost-sharing reduction payments, were necessary.

At the end of today's hearing, Alexander summarized suggestions the insurance commissioners made on ways to adjust the 1332 waiver to make it easier for states to apply and increase flexibility, saying, "I heard three things mostly: reinsurance, cost sharing reductions, and more flexibility for 1332...[F]or the short term... what I've heard is adjust 1332 in any way that makes it easier for you to create your own short-term reinsurance next year...

"Several suggestions for improving 1332 that ought not be too controversial... the six-month waiting period, the "me-too" application-- that is, if Washington puts something in that's approved, why can't Tennessee come along behind it and say, "We want to do what Washington did with one change." That ought to speed things up...

"And the idea of letting the process go ahead with just the application of the governor-- or, as you've suggested, the insurance commissioner-- and not wait for the legislature to have to pass a law since some states' legislatures only meet every two years...

"And then I was intrigued with the suggestion, I've heard it often, of what can we do about the budget neutrality requirement, and make sure that that doesn't keep you from doing what you would do to make a long-term plan?

"And is there any way to include the savings that you have in Medicaid with what you're doing in the individual market, [with] the two different waivers that the federal government has?

"So, that's a short list of some things that might make some real difference in the 23 states that have actually started the process for applying for a 1332 waiver. So I'm hopeful that maybe some combination of continuing cost sharing for a period of time -- and we can discuss what that time is -- and significant changes in flexibility for states... might provide a basis for action we can take this month."

As always, please let me know if you have any questions --

Taylor Haulsee

Press Secretary

Senator Lamar Alexander (R-Tenn.)

Chairman Senate Health Education Labor and Pensions Committee

202-224-8816

TaylorHaulsee@alexander.senate.gov