Immediately after the United States Senate voted Monday to open debate on a repeal of the Affordable Care Act, Washington Insurance Commissioner Mike Kreidler issued a statement stating that the Republican proposal poses a major threat to the 700,000 consumers in Washington state who purchase their own health coverage or qualify for help. The Senate is “playing with fire,” he said.
Now at the end of a week during, despite the fact that the Senate voted on and failed to pass two amendments that would have resulted in a repeal, Kreidler’s office is still eying the fire extinguishers. Spokesman Steve Valandra says that the “skinny repeal” of the ACA, also known as Obamacare, would still have dire consequences for Washington’s insurance market. The skinny repeal, which was expected to come up for a vote on Thursday night, would eliminate the individual mandate requiring Americans to purchase health insurance, as well as a tax on medical devices. While it would leaves the rest of the law intact, Valandra said it would still cause major problems.
The spokesman said the individual mandate creates balance in the risk pool, and the mere possibility of losing just this one ACA component is already creating instability in the insurance market that will lead to higher premiums. He added that this is not just the Commissioner’s opinion, but something he has heard from insurers. If the individual mandate is repealed, the Congressional Budget Office projects that 15 million people in the U.S. would lose insurance.
While members of both parties agree that insurance premiums in the U.S. are too high, the skinny repeal is all but certain to worsen this issue, not alleviate it. The CBO, in fact, estimates that premiums would increase by 20 percent. Now that there is an open-ended motion to proceed for the Senate to vote on any number of amendments to the repeal bill, is there any chance Republicans could find a way to decrease premium costs?
In order to lower premium costs, Valandra says Republicans would likely have to weaken or remove the ACA’s higher standards for insurance. “You could see where premium rates would come down for plans,” says Valandra, “but at the same time, the deductibles go so high they violate current law. It’s what the Commissioner would call ‘junk insurance,’ and it’s of very little benefit.”
So what would need to happen for premiums and deductibles to go down? “Until you’re dealing with actual cost of health care,” says Valandra, “premiums are only going to go higher no matter what.” In King County, 23 percent of consumers are insured through Washington Apple Health or private insurance offered through Washington Healthplanfinder with an average subsidy of $261 per month.
Nonetheless, Valandra says a discussion of drug costs or the inconsistent cost of care from provider to provider—two of the major drivers of the rising costs of health care—doesn’t seem to be among the many possible outcomes of today’s vote. “We don’t see anything in the proposal that could bring costs down,” he says.