CAHC White Paper: ACA Repeal and Replace

Why Health Care Reforms Must Emphasize Market Stabilization And Cost Containment Solutions

The Council for Affordable Health Coverage (CAHC) is a broad-based alliance with a primary focus: bringing down the cost of health care for all Americans. Our membership represents a broad range of interests – organizations representing small and large employers, biopharmaceutical manufacturers, insurers, brokers and agents, patient groups, and physician organizations.

The following proposals address the need for insurance market stabilization and longer-term health care reform and are intended to facilitate further discussion and policy development. These comments reflect the proposals and positions of CAHC, but may not necessarily reflect the individual views of our members.

EXECUTIVE SUMMARY

The Patient Protection and Affordable Care Act (ACA) made massive changes to health markets – some positive and some negative. It created new consumer protections, corrected some market imbalances, and reduced the number of uninsured Americans to historic lows. The program has been rife with political controversy and programmatic challenges, however. While many Americans with significant health needs or lower incomes have greater access to coverage now, the reality is that for millions of others, health coverage is less affordable and more out of reach than when the ACA was enacted seven years ago. Overregulation, mandates, taxes, and fees have contributed to high and growing health insurance premiums, marked by average double-digit price increases for exchange plans. Because of these problems, insurers are exiting marketplaces throughout the country, reducing competition and contributing to a seriously unbalanced and expensive risk pool where consumers have fewer choices. This is leading to a vicious cycle causing healthy consumers to abandon the exchange markets where they are desperately needed to hold coverage costs down over the long-term.

For the second time in less than a decade, Americans now face a major fight over health care reform. President Donald J. Trump and Republican congressional leaders have pledged to immediately work to repeal President Barack Obama’s controversial health system overhaul and replace it with a more flexible, market-driven approach. This holds great promise to correct mistakes in the law that have led to market instability and higher costs. If replacement efforts are not coupled with immediate stabilization efforts, however, markets will continue to deteriorate and the loss of coverage for millions of enrollees will be severe.