Contentiousness surrounding discussions about health care creates ripples that extend well beyond Washington, D.C. Instability fostered by Republican efforts to overturn the Affordable Care Act impacts patients, providers, insurers and even lawmakers in Washington and every other state.
Therefore, it is notable that Sen. Patty Murray, D-Wash., is at the forefront of efforts to provide stability for the health care market. As the ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, Murray has pledged to collaborate with committee chair Lamar Alexander, R-Tenn., when the Senate returns to work in September.
This is preferable to President Trump’s impetuous suggestion that the system should be allowed to collapse. It also is preferable to the damaging partisanship that has surrounded the issue thus far. Any discussion about health care must focus upon those who are directly impacted. This is not a game to be scored by wins and losses; it is a life-and-death situation surrounding an industry that accounts for more than one-sixth of the American economy.
As Sean Gregory, chief executive of PeaceHealth’s Columbia Network, which covers Clark and Cowlitz counties, told The Columbian’s Editorial Board last week: “Our thinking is we cannot design our organizational strategy around government policy. … We think Medicaid is going to be here in one shape or another, and we’re advocating that expansion remain. We think it’s the right thing for the public, and it’s certainly consistent with a faith-based, not-for-profit health system.”
Meanwhile, health care also has the attention of lawmakers in the state. Local Republican representatives Brandon Vick, Paul Harris, and Vicki Kraft told the Editorial Board that turmoil at the federal level creates doubt here. As Kraft said: “Once that gets decided, that’s going to have a ripple-down effect.”
The Medicaid expansion that accompanied the 2010 passage of the Affordable Care Act — colloquially known as Obamacare — is one of the key issues. So, too, is bolstering the market to lure insurers. Trump has threatened to halt payments that offset expensive-to-cover clients for insurers — a move that would destabilize the market. As Alexander said: “There are a number of issues with the American health care system, but if your house is on fire, you want to put out the fire. The fire in this case is the individual health insurance market.”
Alexander has asked the administration to continue payments through September, giving Congress time to forge a short-term solution. The payments, which are known as cost-sharing reductions, are particularly prevalent in states that supported Trump in last November’s election, with Mississippi, Alabama, Florida and South Carolina having the highest percentage of marketplace enrollees qualifying for subsidies.
That is a reality that will befuddle pundits for years to come. But the fact that people often vote against their own interests should not absolve Congress of its duty to improve the Affordable Care Act rather than scuttle it. In that regard, Murray and Alexander represent the best hope for patients and providers. In 2015, they created a bipartisan update of education policy, devising the Every Student Succeeds Act. In 2013, Murray worked with Rep. Paul Ryan, R-Wisc., to create a bicameral budget agreement.
Bipartisanship often is viewed as a pejorative these days in Congress. But when it comes to the ongoing debate over health care, it is exactly what the doctor ordered.