On August 30, 2017, a bipartisan coalition of Governors issued a letter to Congress on steps needed to restore stability and affordability in coverage to 22 million Americans served through individual health insurance markets under the Affordable Care Act (ACA). The Governors’ letter sets the stage for testimony before a US Senate committee on September 7, 2017, by Massachusetts Governor Charlie Baker, Montana Governor Steve Bullock, Tennessee Governor Bill Haslam, Utah Governor Gary Herbert, and Colorado Governor John Hickenlooper.    

The Governors’ recommendations for market stabilization include: reauthorization of Congressional funding for cost-sharing reductions and reinsurance for at least two years, retention of the individual mandate, and tax incentives for health insurers to offer plans in under-served counties.  

Recommendations to preserve coverage gains and control costs include: continued funding for outreach and enrollment initiatives, more effective enrollment procedures, and more flexibility for states to redesign coverage standards. Recommendations to improve federal/state collaboration include: more efficient procedures through which states may obtain federal waivers, procedures to let states easily replicate waivers approved in other states, and fast-tracking waiver extensions. The letter also includes a menu of state reform options to supplement federal reforms, such as population-based and episode-based payment models that reward effective management of care. 

The Governors’ testimony will be provided to a Senate health committee which is now seeking to develop bi-partisan ACA amendments rapidly based on the testimony of leading state officials and other key stakeholders. Additional information is available here.