By Harris Meyer | July
11, 2017
Two former federal health program chiefs—one a Republican, one a
Democrat—have proposed a way for Senate Republicans to break through their
current logjam in passing a healthcare reform bill.
They recommend stripping out the Senate GOP bill's controversial Medicaid cuts and restructuring and considering those issues later.
Congress should separate changes to the Medicaid program from the more pressing task of stabilizing and improving the individual health insurance market, wrote Andy Slavitt, CMS administrator during the Obama administration, and Gail Wilensky, Medicare and Medicaid chief in the George H.W. Bush administration in a new JAMA Forum piece.
That would include deferring consideration of the GOP plan to phase out the Affordable Care Act's Medicaid expansion.
They recommend starting a 12-month bipartisan review process that focuses on long-term Medicaid reforms to improve care and reduce costs. "Congress can and should commit to improving and modernizing Medicaid, but the process will take time to develop bipartisan support for the changes that are needed and should not be rushed," they wrote.
Their proposal is in line with the views of many state leaders, provider and insurance groups, and policy experts that Medicaid is too big, important, and complex a program to restructure within the rapid GOP time frame for passing legislation to repeal and replace the Affordable Care Act.
But Wilensky acknowledged their proposal will only get traction if Senate Majority Leader Mitch McConnell fails to round up the needed 50 GOP votes to pass his bill. He announced Tuesday he is delaying the start of the August recess for two weeks to give the GOP caucus more time to reach agreement.
"I'm enough of a realist to know that if they can get the votes to do it, they'll do it now," Wilensky said.
They recommend stripping out the Senate GOP bill's controversial Medicaid cuts and restructuring and considering those issues later.
Congress should separate changes to the Medicaid program from the more pressing task of stabilizing and improving the individual health insurance market, wrote Andy Slavitt, CMS administrator during the Obama administration, and Gail Wilensky, Medicare and Medicaid chief in the George H.W. Bush administration in a new JAMA Forum piece.
That would include deferring consideration of the GOP plan to phase out the Affordable Care Act's Medicaid expansion.
They recommend starting a 12-month bipartisan review process that focuses on long-term Medicaid reforms to improve care and reduce costs. "Congress can and should commit to improving and modernizing Medicaid, but the process will take time to develop bipartisan support for the changes that are needed and should not be rushed," they wrote.
Their proposal is in line with the views of many state leaders, provider and insurance groups, and policy experts that Medicaid is too big, important, and complex a program to restructure within the rapid GOP time frame for passing legislation to repeal and replace the Affordable Care Act.
But Wilensky acknowledged their proposal will only get traction if Senate Majority Leader Mitch McConnell fails to round up the needed 50 GOP votes to pass his bill. He announced Tuesday he is delaying the start of the August recess for two weeks to give the GOP caucus more time to reach agreement.
"I'm enough of a realist to know that if they can get the votes to do it, they'll do it now," Wilensky said.
Harris Meyer is a senior reporter providing news
and analysis on a broad range of healthcare topics. He served as managing
editor of Modern Healthcare from 2013 to 2015. His more than three decades of
journalism experience includes freelance reporting for Health Affairs, Kaiser
Health News and other publications; law editor at the Daily Business Review in
Miami; staff writer at the New Times alternative weekly in Fort Lauderdale,
Fla.; senior writer at Hospitals & Health Networks; national correspondent
at American Medical News; and health unit researcher at WMAQ-TV News in
Chicago. A graduate of Northwestern University, Meyer won the 2000 Gerald Loeb
Award for Distinguished Business and Financial Journalism.
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