Hickenlooper, Kasich Discuss Bipartisan Health Reform Proposals and Remaining Challenges

A day after a group of bipartisan governors testified before the Senate Health, Education, Labor, and Pensions Committee on stabilizing the individual insurance markets, Ohio Governor John Kasich and Colorado Governor John Hickenlooper sat together at an event co-hosted by the American Enterprise Institute and the Center for American Progress to discuss bipartisan consensus around health reform policies.

Hickenlooper, a Democrat, and Kasich, a Republican, discussed the bipartisan set of proposals they released to stabilize the markets and reform the healthcare law, and Kasich noted that the idea was to give more flexibility to states without getting rid of protections.

“I think it threads the needle in terms of giving states more power, but at the same time making sure they don’t just do whatever they want,” he said, adding that it is important to have guardrails in place, without restricting innovation.

Hickenlooper took a look at the aspects of their proposal that could help stabilize the markets, notably guaranteeing payment of the cost-sharing reduction (CSR) payments to insurers and setting up a reinsurance fund. Alaska was one of the models for reinsurance—the state has reduced premiums by close to 35% because the reinsurance fund means insurers are able to cover costly patients without raising premiums on the whole population.

Hickenlooper had been one of the governors to testify before the Senate panel the day before, and he said that there was a clearly different tone about the discussion. Instead of feeling like one side was attacking, while the other embraced, both parties were supportive.

“We all pretty much agreed on CSRs, on a reinsurance pool,” Hickenlooper said. “There was a commonality there. It felt good.”

There has been a new sense of urgency and a new openness to bipartisan work on healthcare that both governors noted. For too long, Republicans didn’t want to be connected to anything related to the Affordable Care Act, while Democrats didn’t want to be connected to anything seen as eroding the law, Kasich said. However, the public is “getting fed up” with the partisan politics.

He urged people to “drop the labels” around health plans. Instead, Republicans and Democrats should just view it as creating decent healthcare for Americans.

“I want to have a marketplace where people can buy insurance, and if people can’t afford it, let’s give them money,” so they can buy insurance and don’t end up in the hospital when they get sick. “We believe in the exchanges, we believe in the private market, and we also happen to believe in Medicaid. For people who are really poor, let’s help them out and get them back on their feet.”

The biggest challenge, however, remains getting people enrolled. Without the individual mandate, there have to be other options and tools for getting healthy people signed up for health plans in the marketplaces.

Hickenlooper explained that they are trying to figure out ways to make health insurance attractive, through incentives or discounts, and ways to involve trusted advisors to encourage young people to enroll.

“We’re going to give Ed Sheeran tickets out to any young people who sign up,” joked Kasich.

The long-term solution for healthcare and stabilizing the markets is to provide quality over quantity, he added. Both governors are committed to getting rid of “quantity medicine,” Kasich said.

Ohio’s Medicaid plan is in managed care, which has actually managed care for patients and curbed costs. This is something that could be done in Medicare, too, Kasich said. Instead of fee-for-service being the default in Medicare, managed care should be the default option.

“We actually want a market that rewards quality, not quantity,” he said.