Democratic Govs. John Hickenlooper of Colorado and Tom Wolf of Pennsylvania, Republican Govs. John Kasich of Ohio and Brian Sandoval of Nevada, and Independent Gov. Bill Walker of Alaska discussed their plan at the National Press Club in Washington, D.C.
Their proposal -- which expands on a letter they wrote to Congress in August -- is aimed at stabilizing the marketplace, making plans more affordable and giving states more flexibility.
The governors made a point to argue that, despite the partisan rhetoric in Congress, the goals of delivering high-quality care and reducing costs or covering more people and being fiscally responsible are not mutually exclusive.
“We reject these false choices," they wrote. "Other sectors of the economy have delivered greater output at lower cost over the last 30 years. We should expect the same high performance and continuous improvement from our health care system."
They are urging President Donald Trump to restore cost-sharing reduction payments to insurers, which pay for the subsidies that most low-income people on marketplace plans receive. The White House ended those payments in October, triggering premium hikes.
The governors also encouraged the federal government to approve and help fund more state reinsurance programs, which protect insurance companies from the most expensive patients. Alaska has a successful reinsurance program that has kept marketplace premiums steady while other states have seen prices skyrocket.
More innovation in state Medicaid programs, they say, is needed. In particular, states should shift away from a fee-for-service model to a value-based system of care. To do that, they're asking for investments in transition plans to make the change easier.
The governors also recommend Medicaid programs to incorporate the idea that making people’s living environments better -- clean air, safe housing -- will make them healthier overall.
Governors were instrumental in blocking Republican efforts last year to repeal and replace the Affordable Care Act (ACA), President Barack Obama's signature legislation. But with repeal efforts seemingly over and health care on the backburner as immigration and gun laws take center stage, some people are skeptical of the influence these governors could have.
“The people who signed that letter are moderates. Moderates don’t control Congress,” Gail Wilensky, a health care economist who was administrator of the Centers for Medicare and Medicaid Services during the H.W. Bush administration, told Governing back in August.
*CORRECTION: A previous version of this mistakenly stated that U.S. GOP Sen. John McCain cited his home-state governor, Republican Doug Ducey, as a reason he infamously voted against a repeal bill in July. Ducey, in fact, supported the repeal bill at the time.
