A radical idea: Working together to fix the American health care system

Recently the Senate voted late into the night on a Thursday and into the early hours of Friday morning, ultimately voting down a bill that would have rolled back many parts of the Affordable Care Act. It was the right choice given the rushed nature of the process and the uncertainty of the impact the bill would have on one sixth of the American economy and on millions of people across the country, including tens of thousands in Maine. Now I have a radical idea to propose: Let’s work together. Let’s hold hearings, and listen to health professionals, patients and people from the insurance community to better understand how we can fix the Affordable Care Act and make commonsense decisions that address the underlying costs of health care, which are far too high in this country.

There are many ways Congress can make productive improvements to the health care system with support from members of all political stripes, which is why I’ve signed onto 10 bills that seek bipartisan solutions to improve market stability and lower costs for the American people.

Improving Market Stability:

Marketplace Certainty Act – This bill would make cost-sharing reduction payments permanent and expand eligibility up to 400 percent of the federal poverty level. Ensuring that these payments are made would address bipartisan concerns about market stability and unaffordable cost-sharing expenses, such as deductibles and copays.

Health Care Options for All Act – This bill would allow people who live in counties with no exchange plans offered to buy plans from the DC Exchange, just like members of Congress and their staff. It would provide a simple solution to concerns raised in rural counties that don’t have any health insurance plans offered, while reaffirming the premise that American citizens deserve access to the same health insurance made available to members of Congress.
Individual Health Insurance Marketplace Improvement Act – This bill would create a permanent reinsurance program and stabilize premiums. Reinsurance is a well-established, bipartisan method of ensuring stability in a number of programs, from Medicare Part D to crop insurance.

States Achieve Medicaid Expansion (SAME) Act – This bill would provide each state expanding its Medicaid program with the same levels of Federal matching funds, regardless of when it chooses to expand the program. Medicaid expansion has been supported by many Republican and Democratic governors and state legislators.

Commonsense Competition and Access to Health Insurance Act – This bill would direct state insurance regulators to develop models for states to sell health insurance across state lines. Allowing insurers to sell insurance across state lines is widely supported by members of the Republican caucus and establishing policy to make this process work more effectively will encourage insurers to pursue this opportunity.

Lowering Healthcare Costs:
Addressing Affordability for More Americans Act – This bill would address the subsidy cliff in the ACA for people with incomes higher than 400 percent of the federal poverty level (FPL), gradually scaling down the subsidy for people with incomes up to 800 percent FPL. Under current law, an individual earning $45,000 per year would be ineligible for any subsidies to purchase health insurance. Due to bipartisan concerns about premium affordability, it makes sense to gradually scale down for people with higher incomes to ensure middle class Americans can afford quality insurance.

Safe and Affordable Drugs from Canada Act – This bipartisan bill would allow for the importation of drugs from licensed Canadian pharmacies for personal use if they have the same active ingredients, route of administration, dosage form, and strength as a prescription drug approved by the FDA.

Affordable and Safe Prescription Drug Importation Act – This bill would expand upon bipartisan efforts to allow for the importation of prescription drugs from licensed Canadian sellers and, after two years, the Secretary of Health and Human Services would have the authority to permit importation from other OECD countries

Medicare Prescription Drug Price Negotiation Act – This bill would lower prescription drug prices for seniors by allowing Medicare to negotiate the price of prescription drugs. This legislation would help cut costs for nearly 41 million seniors enrolled in Medicare Part D and boost Medicare savings. President Trump has expressed support for negotiating the price of prescription drugs under Medicare dating back to the presidential campaign, and this support has been reaffirmed in statements made as recently as this spring.

Medicare Drug Savings Act – This is a bill I’ve supported since I arrived in the Senate in 2013. It would eliminate a special deal for brand-name drug manufacturers that allows them to charge Medicare higher prices for prescription drugs for some seniors and people with disabilities, including about 97,000 Mainers. The bill would require drug companies to provide rebates to the federal government on drugs used by dual eligibles – people eligible for both Medicare and Medicaid, who are predominantly low-income seniors – just as was done for dual eligibles on Medicaid before Medicare Part D was created in 2006.

There is much room for common ground in the health care debate. It’s time to roll our sleeves up and get to work on solutions that help people in Maine and across the country access high-quality affordable health coverage.