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Health Care Next Steps: Listen, Learn, and Strengthen Today’s Marketplace

As I listen intently to members of Congress, thought leaders and members of the Trump administration, I am encouraged by how Congress and President Donald Trump came together in the last week to supply urgently needed aid to the victims of Hurricane Harvey. They responded to the emergency with overwhelming bipartisan support, and they may need to do so again rapidly for storm victims in Florida.

I am also heartened by what could be an emerging, bipartisan health policy direction to respond to struggling individual insurance markets — at least in the near term. While we must engage over the long term about how to restructure the health care marketplace, we need to increase the chances right now for the existing marketplace to succeed. This means policymakers should consider immediate legislation to appropriate funds for cost-sharing reductions that help the most vulnerable afford insurance and provide states more flexibility to demonstrate different ways to achieve the goal of increasing coverage and decreasing costs.

I applaud Chairman Lamar Alexander and ranking member Patty Murray of the Health, Education, Labor and Pensions Committee in the Senate for scheduling four committee hearings this month on short- and long-term health care reform. One of the witnesses at the second hearing was Gov. John Hickenlooper of Colorado. He joined with Ohio Gov. John Kasich and a bipartisan group of six other governors on Aug. 30 to outline a commonsense, short-term approach to strengthen the existing markets, jump start state innovation and more effectively control costs.

Their recipe for achieving these goals includes funding the CSRs through 2019; creating a temporary state stability fund; keeping the individual mandate for now; and adding flexibility and a fast track process to the state waiver process, among a number of other thought-provoking ideas.

Others are coalescing around similar bipartisan proposals. The Bipartisan Policy Center’s Future of Health Care expert panel called for a two-stage approach to health care reform. First, the panel advocates for stabilizing the individual insurance market and then taking on the more challenging task of addressing the more fundamental structural challenges in our health care system. The BPC’s recommendations are similar in scope and content to the eight governors’ letter. The BPC recommends a two-year extension of the CSRs, a health insurance stability fund, greater use of health savings accounts and a study of alternatives to the individual mandate.

While details will differ and must be worked out, Ascension applauds the efforts of each of these groups of thought leaders in driving consensus around a short-term bill that will strengthen the health care marketplace. Ascension supports continued funding of the CSRs. We believe that the parties should engage on ways to increase flexibility for states so that they can unleash innovation and creativity on expanding coverage and decreasing costs. We hope that the federal government and states will do more to hasten the transformation of our health care system to one that rewards value rather than volume. The kind of flexibility that allows more proactive experimentation with value-based financing should be applauded.

Strengthening the health care marketplace is an issue that unites policymakers, thought leaders, consumers, providers and insurers, and there is a spark of agreement forming across the political parties. All of us want a strong marketplace, and it is essential we get the right premium rates, care delivery networks and care management programs in place to stabilize the marketplace. While thought leaders and policymakers differ markedly on how that marketplace should be constructed for the long term, all of us agree that the marketplace that we have right now should be as strong as possible in the near term to serve all of us, especially those most vulnerable. Congress should act now to take the steps needed to strengthen today’s health care marketplace. For those without access to affordable insurance, it is an emergency. Every health care consumer will benefit, and it would provide us the opportunity to then re-engage in the fundamentally important debate about how to structure the marketplace for the long term.


Anthony R. Tersigni, EdD, FACHE, is president and CEO of Ascension, the nation’s largest nonprofit health system.

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