The political divide over the insurance provisions of the Affordable Care Act looks to be unbridgeable for now, but out of public view, Republicans and Democrats are quietly forging a consensus on an even more consequential aspect of medical care: improving its value for all Americans by increasing its quality and lowering its cost.
In December 2017, the Republican Congress, working with the Trump administration, repealed the tax penalties enforcing the Affordable Care Act’s (ACA) individual mandate, effective in 2019. Although the degree of the mandate’s efficacy is uncertain, its repeal is sure to lead to additional Americans going without coverage, exacerbating the instability that now affects the individual insurance markets of many states.
Republicans in Congress and the Trump administration repealed the penalties associated with the Affordable Care Act’s individual mandate in the tax act that passed in December. Now they need to replace the mandate with something that will address rising premiums and command broader support. Automatic enrollment into health insurance plans is a good place to start.
As the discussion over the future of health reform continues in the United States Senate, some Republicans are looking for ways to boost coverage levels, help stabilize insurance markets, and lower health costs. For years, the U.S. has had insurance enrollment levels below what was possible because of lower than desirable take-up of existing options.
If the Supreme Court rules in favor of the plaintiffs in the King v. Burwell case, Congress will have the opportunity to advance health care policies that expand consumer choice, increase coverage, deliver better value for the dollar, and allow state governments more say over health care policy.