The old saw has it that nothing is certain in life except death and taxes, but supporters of the Affordable Care Act have reason to feel increasingly confident about its durability.
Signed into law by President Obama almost 10 years ago, it’s withstood an assortment of legal challenges and survived by one vote in the U.S. Senate when the Trump administration attempted to repeal it in 2017. A federal judge in Texas declared that the law was unconstitutional last year, but most observers believe that if the judge’s decision is somehow upheld by the U.S. Supreme Court, the backlash would be grievous – while not yet as widely loved as Social Security or Medicare, it has slowly but steadily gained majority support.
Armed with the assumption that the Affordable Care Act is not going anywhere anytime soon, state lawmakers have put forward a measure that would have the state take the reins of the exchange that sells health insurance in Pennsylvania. Right now, the online marketplace is being operated by the federal government, with Pennsylvania paying Uncle Sam about $94 million each year to do so. Under the proposal, the cost for the state is projected to be only $30 million to $35 million.
At a moment when bipartisanship is mostly a chimera in both Harrisburg and Washington, D.C., this measure truly does have the support of both parties. It was introduced by state Rep. Bryan Cutler, a Lancaster-area Republican, and Frank Dermody, a Democrat whose state House district spans Allegheny and Westmoreland counties. It also sailed through the House Tuesday, with the Republican-controlled body getting behind it on a 198-1 vote. Gov. Tom Wolf is also a proponent of the plan, saying he would like to see Pennsylvania operating the exchange by 2021.
In an op-ed for PennLive, Cutler and Dermody wrote, “This isn’t a Republican or Democratic issue, it’s a people issue. It’s not red vs. blue, it’s all green. It’s a great example of how we can and should work together to make sure everyone can afford to see a doctor when they get sick, and our job-creating health care industry has customers who can pay their bills.”
The savings that Pennsylvania would realize would go toward lowering premiums. The money that would have gone to Washington, D.C., will instead be put toward a reinsurance program that reimburses insurers when they are confronted with some kinds of high-cost claims. Pennsylvania would be the first state to pay for its share of the reinsurance program by managing its own exchange, according to Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. She told the Associated Press that most other states pay for their reinsurance programs through assessments levied on insurance companies and hospitals.
Right now, 12 states have their own exchanges, and four other states are in the process of establishing them. Given the savings involved and the benefits that would flow to consumers, the state Senate needs to approve this plan promptly and get it to Wolf’s desk.