Opinion-Editorial, The Hill
Martin Hickey, MD, CEO of New Mexico Health Connections
December 6, 2016, 10:50 a.m. EST
Threats to the future of ObamaCare have been almost endless since the day it was signed into law. The landmark Affordable Care Act has faced multiple legal challenges, dozens of Congressional repeal votes, implementation headaches, and four election cycles waged at least partially on its merits. With a new administration and Congress coming to Washington united in their intent to repeal or significantly modify the law, the ACA is seemingly facing its greatest threat yet.
Though rarely front and center in this high-profile debate, health insurance CO-OPs have nevertheless found themselves endangered by the biennial uncertainty it creates. When we were not affected by the various challenges to the law itself, the obstacles of being start-up businesses combined with unfavorable policy changes proved to be obstacles many CO-OPs couldn’t overcome.
Though it would be easy to view CO-OPs’ present and future circumstances with skepticism, the six CO-OPs operating in eight states actually have reason to be more confident now than ever.
They have weathered very violent storms, and come out on the other end stronger and seasoned. And, our optimism about the future includes one in which the Affordable Care Act looks very different than presently. Put simply, there’s a lot for both Democrats and Republicans to like about health insurance CO-OPs.
CO-OPs are boosting competition. In some states, CO-OPs are one of the few alternative options to existing commercial insurers, giving consumes the choice and competition they deeply desired. And unlike many brand-named insurers, CO-OPs are not abandoning the marketplaces and the Americans who rely on them for their health insurance needs.
We are instead diving head first to give people who had long had difficulty in obtaining health coverage the options previously unavailable. We don’t run from customers pre-existing conditions; we welcome them into our family, and provide them the treatment they need to remain or become healthy.
CO-OPs are keeping prices in check, to the benefit consumers and the federal government alike. In 2014 and 2015, analyses indicated states with CO-OPs boasted significantly lower premiums than those without, meaning even those who didn’t enroll in a CO-OP benefited from lower relative premiums across the board.
The taxpayer and federal treasury benefited, too. Lower premiums mean the government spends less than it otherwise would on premium subsidies. Competition works; always has, always will.
CO-OPs are already operating outside of the marketplaces. While CO-OPs are required to sell plans on the marketplaces, all have significant other insurance business. In New Mexico, 70% of our business does not receive federal exchange subsidies because we have so many large and small business customers, as well as individuals and families who do not qualify for subsidies. Like almost all businesses, we value diversification.
Other CO-OPs made strategic business decisions to focus on non-ACA business when healthcare.gov and state-operated marketplaces were slow to launch. These smart decisions and a diversified portfolio have helped us survive and put us on stronger footing to address unexpected challenges.
CO-OPs are small businesses and innovative start-ups. Conservatives and liberals alike are fond declaring that small businesses are the backbone of the economy. We agree.
As small businesses hyper-focused on our communities, we are able to deliver the type of insurance that best serves our customers. This means significant innovations to improve patient care, like what New Mexico Health Connections is achieving with its intensive Medical Management and Shared Savings Program that rewards providers for positive health outcomes. Or Patient-Centered Medical Homes in Maryland that take a holistic and comprehensive approach to patient care.
CO-OPs have been the incubators to test new ideas that can and will be applied on a much wider basis.
Regardless of the new Congress’s and Administration’s approach to solve our health care challenges, the remaining CO-OPs have proven their value in both the health insurance marketplace and the marketplace of ideas. They can and should be a part of America’s health insurance landscape for decades to come.
In the meantime, CO-OPs will continue to do what they’ve learned to do best: enroll customers and provide them with high quality and innovative health insurance.
Dr. Martin Hickey is Board Chair of the National Alliance of State Health CO-OPs, and CEO of the CO-OP in New Mexico: New Mexico Health Connections.
The views expressed by authors are their own and not the views of The Hill.