The Political Page, T+215 -- The Train Has Come Off The Tracks -- August 23, 2017

Max called it a train wreck, even though he voted for it, and then promptly left the US Senate. We've been watching that train wreck in slow motion. The Republican-led US House and US Senate who sent up "repeal and replace" bills on a regular basis to a Democratic president were unable to replicate those actions when they had a president who promised to sign any such bill to "repeal" ObamaCare.

The result?

The train has come off the tracks.

The most recent state that has taken action to save some passengers is Iowa. From The Wall Street Journal:

Iowa asked for federal permission to alter major provisions of the Affordable Care Act next year, a proposal that will be closely watched by officials in other states who hope to rewrite parts of the health law as Republican efforts to do so in Congress have stalled.

Iowa’s plan, which state officials said they are already preparing to implement pending federal approval, would go further than proposals that other states have made so far to revamp the health law’s rules. The Iowa setup would offer just one type of insurance plan in the individual market and reshape the subsidies that help people buy coverage, among other changes.

State officials, who are formally filing for federal approval under a special waiver setup allowed by the ACA, argue they need to repair an exchange market that is expected to be down to just one insurer that has requested sharp rate increases for 2018.

States including Idaho, Minnesota and Oregon have submitted applications for less-sweeping waivers that aim to blunt insurers’ expense for covering the claims of people with costly health conditions.

In total, 13 states have passed laws authorizing state officials to craft ACA waiver requests, according to the National Conference of State Legislatures. At least six others are considering such legislation.

“The most urgent thing for states is to stabilize the markets,” said Rosemarie Day, a health strategist and former chief operating officer of the Massachusetts exchange. But the waiver process also “opens the door to trying to accomplish some things Republicans are trying to do,” like limiting benefits currently required under the ACA. “This could be a backdoor way.”

OMG, a backdoor way. Well, if Schumer and McCain are blocking the front door ... 

Some states, such as Oklahoma, have signaled they intend to seek waivers that, like Iowa’s, could make big changes to the ACA. If those proposals proceed and are granted by the Trump administration, the upshot could eventually be a patchwork of different insurance setups across the country. However, the ACA includes firm conditions that such waivers must meet, including that coverage must be as affordable and comprehensive as it is under the federal law’s setup.

"Must be as affordable...." Don't make me laugh. That's an easy bar to meet. And as comprehensive as the federal law -- look at the bronze plans -- about the only thing they guarantee is family planning and end-of-life counseling, also easy bars to jump.

Iowa Insurance Commissioner Doug Ommen, a Republican, said the state has worked with the federal Centers for Medicare and Medicaid Services and that it hoped to get its new system up and running before individual-plan enrollment kicks off in November.

“We’re doing everything that’s needed to start it up as though we already had a yes,” he said. Iowa is also asking federal officials to move faster than the 180-day waiver review timeline designated by the ACA.

The founding fathers, even if some were slaveholders, had great sense when it came to states' rights.

*********************

Fox Business 

Provides background to the two September, 2017, deadlines.