Skip to main content


Kasich-Hickenlooper is No Cure, But Could Keep ACA Alive

By Gregory A. Freeman  
   September 20, 2017

A healthcare reform proposal from two governors could improve the Affordable Care Act, but it won't cure what ails the insurance market. It might, however, be the best option for now.

All eyes are on theGraham-Cassidy proposal to dismantle the Affordable Care Act, but a healthcare fix proposed by two of the nation's highest-profile governors is also in the offing.

While the joint plan includes solid proposals it isn't enough to save the floundering Affordable Care Act, one analyst says. Still, the proposal might be enough to keep the ACA alive until a cure comes along.

Colorado Governor John Hickenlooper, a democrat, and Ohio Governor John Kasich, a republican, hope their proposal will get bipartisan support in Congress.

They propose keeping the ACA's individual mandate, which fines Americans who go without insurance the greater of 2.5% of income or $695, calling the mandate a "major factor in encouraging healthy young people to get coverage and avoiding a collapse in the marketplace."

Kasich and Hickenlooper are also calling for President Trump to continue funding the cost-sharing reduction (CSR) subsidies that reimburse insurers for covering certain out-of-pocket costs for low-income people. They also propose allowing states greater flexibility in "pursuing innovative strategies to preserve coverage" by seeking waivers from ACA rules.

Related: CSR Loss, Rising Employment May Hurt Health Plans

Some parts of the proposal are necessary to prop up the ACA while other improvements are contemplated, notes Michael Abrams, managing partner with Numerof & Associates, a strategy development and implementation consulting firm.

Real reform will require tackling the deeper issue of why healthcare is so expensive and reworking how providers are reimbursed for value and quality, he says.

"People are talking in terms of stabilizing the insurance market for the next two years. It's the 11th hour and we're just looking for ways to keep this thing alive a little longer."

Gregory A. Freeman is a contributing writer for HealthLeaders.

Get the latest on healthcare leadership in your inbox.