Trump Should Borrow Obama’s Health Playbook


If President Donald Trump wants to help struggling insurance markets, he should follow his predecessor’s example of sending staff to meet with state insurance regulators and insurance companies, the former head of the Centers for Medicare & Medicaid Services told me recently.

Thus far, the Trump administration has acted consistently with Republicans, choosing to “repeal funds, not pay cost-sharing reductions, talk down the market by saying it’s going to explode, and scare insurers out of the market,” Andy Slavitt, former acting administrator of the CMS, said.

But if they worked with states and insurers to make sure they had as much health-care coverage as possible, it would be a step forward.

The administration should reassure states and insurers it wants as much coverage as possible, and wants to help create competition and save the markets, Slavitt said. For example, he sent staff to Arizona in the summer of 2016 because the market there wasn’t profitable and insurers had questions. That effort to listen and solve problems could be a lesson for the Trump administration, he said.

“I had an insurer tell me the other day they’re unlikely to enter and participate in the marketplace because there will be no near-term support from the administration,” Slavitt said.

The CMS also has tools that could help strengthen markets, like the Affordable Care Act’s Section 1332 State Innovation Waivers. Two states have used this section to add reinsurance pools that help insurers underwrite certain risks. If the CMS advertised those mechanisms “as solutions,” and offered to help states work applications, it would be a boon for markets, Slavitt said.

Read the full story featuring an interview with Slavitt here.

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