As work progresses to undo the problems that Obamacare brought to health care, I believe the road map to responsible reform must take both coverage and cost into consideration. Only then can reform ensure that Americans, especially those recovering from mental illness or drug addiction, receive the care they need while also protecting taxpayers from unsustainable cost growth.
Obamacare severely disrupted the insurance marketplace, especially in states like Ohio, where a history of sound regulation attracted many insurers who then offered a wide range of choices at affordable prices. Our first priority should be to restore stability.
The Trump Administration has begun this process, but there is more that can be done through executive action to fix the Health Insurance Exchange. I encourage them to make additional, badly needed changes so we can help those Americans who do not have employer-sponsored coverage or government health care, while reducing the pressure on state Medicaid programs.
The Administration should allow states greater flexibility to define essential health benefits. Also, because of Obamacare, more consumers could lose in the future the coverage they prefer because their plans don’t meet standards the bureaucrats like. Let consumers keep the plans they want.
Not all of Obamacare’s flaws can be fixed by executive action. Congress shouldn’t force young, healthy people to pay more than they should for coverage, and they can fix this by relaxing the rigid age rating bands that are driving up costs for this group.
It is critically important that the president and Congress act quickly to stabilize commercial insurance markets. States like Ohio want to shift Medicaid enrollees off public assistance to private insurance. I have consistently supported flexibility for states to cover adults through Medicaid up to 100% of poverty, not the higher level mandated by the law. However, before making this transition and moving residents off Medicaid, which is stable, the alternative needs to be just as stable.
When I took office, Ohio Medicaid was growing 9% annually. Now, as a result of aggressive reforms, our state budget holds Medicaid spending growth to less than 3%. Ohio spends the same per person in Medicaid today as we spent six years ago. And we reduced the number of state employees required to administer the program 33% over the past three years.
In addition to being fiscally conservative, Ohio is providing 700,000 low-income residents with a stable source of coverage through Medicaid, including 500,000 residents with behavioral health needs who previously relied on county‐funded services or went untreated.
I cannot emphasize enough the importance of providing a stable transition for those who have gained coverage. Eliminating coverage without a viable alternative would be counterproductive and unnecessarily put at risk our ability to treat the drug addicted and mentally ill who now have access to a regular source of care and treatment services.
In recent weeks, I have been working with congressional leaders and fellow governors to develop a road map toward successful, pragmatic health care reform. As leaders in Washington continue their work, they must resist those who want to let partisan rhetoric set policy. That could result in gridlock or, worse, a significant loss of coverage for those who need it most and additional chaos in the market.
There is a path forward, based on the road map I’ve laid out and many states support, if our leaders in Washington are willing to partner with states to achieve meaningful health care reform.
Mr. Kasich is Republican Governor of Ohio. This piece originally appeared on Forbes.com on Feb. 24, 2017.
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