Marsh McLennan Agency hosted a forum on the Future of Health Care on March 14, 2017. The featured speakers were Mary Brainerd, outgoing CEO and President of HealthPartners, and Representative Erik Paulsen from Minnesota’s 3rd District.
This was the single most well attended event ever hosted by MMA, which is a strong indication that healthcare remains an incredibly important topic for business.
The forum was held ten days before the American Health Care Act (AHCA) was pulled from consideration in the House of Representatives. The AHCA was the Republican plan to repeal and replace the Affordable Care Act (ACA), commonly referred to as “Obamacare.”
Mary Brainerd, Healthpartners
Ms. Brainerd spoke first and reminded the audience, as well as Rep. Paulsen, that she was not a policymaker– but that whatever healthcare legislation is eventually enacted, she is responsible for making it work.
She made it clear that a polarized approach and not addressing the fundamental cost of delivery would seriously impair our country’s ability to afford the level of health care to which we have become accustomed. “No one is addressing the affordability of healthcare delivery,” she said. “That is the great unmet challenge.”
“I reject the idea of ‘replacing’ the Affordable Care Act,” said Ms. Brainerd. “It needs fixing and that’s a big challenge.” As a way to provide coverage for more Americans, the ACA was a “win,” according to Brainerd. But she reminded the audience that the ACA was had many problems that caused unintended consequences, including far higher premium costs.
Speaking specifically about Minnesota, HealthPartner’s coverage area, Ms. Brainerd explained that Minnesota’s uninsured rate is rising and that employer-sponsored plans have experienced a small uptick, after nearly two decades of losing ground.
She went on to say that problems such as better healthcare access in rural areas and effectively dealing with high risk pools – the small percentage who use the most healthcare – must be addressed if we are to create a healthcare system that is also affordable and sustainable.
Brainerd closed her comments by emphasizing three essential needs for stabilizing and improving health care: 1) bringing the community together to create a healthier society; 2) putting more emphasis on primary and pediatric care; and 3) promoting better integration between federal and state government efforts.
Rep. Erik Paulsen
3rd District Congressman Erik Paulsen opened his remarks by explaining what a tremendous responsibility it was to now be in the governing majority. The priorities for the near-term, he said, were reforming healthcare and the tax system.
Rep. Paulsen outlined his perspective on health care, spelling out what he believed constituted an effective system:
- Providing a health care system that lowers costs and assures access
- Promoting quality health care over quantity
- Addressing the drivers of health care costs, including chronic conditions
- Ensuring that patients get the right care at the right time
In order to accomplish that, Rep. Paulsen stated, “we must promote wellness and prevention; make billing and payment far more transparent; create better-educated health care consumers; and provide access for everyone.”
The issues with the current ACA legislation are, according to Paulsen, that it caused more problems than it solved. It discouraged competition and promised consumers something it couldn’t deliver.
One of the biggest problems with the ACA, according to Paulsen, was that it failed to attract younger people, causing premium price increases because the insured pool was older and less healthy than had been predicted. He also argued that incenting participation, as the AHCA bill does, will prove more successful than legislating and subsidizing participation, which was at the core of the ACA.
At the time the Forum was held, Rep. Paulsen defended the AHCA as health care replacement that would bring stability to the marketplace, provide relief from taxes and mandates, and replace the flawed concept of subsidies.
In closing, Rep. Paulsen stated that “true health care reform will only happen through bipartisan efforts to encourage more and better primary care, use of Health Savings Accounts, chronic care reform, and reform of the medical liability system.” He also encouraged returning more control to the individual states so they can use federal dollars as they see fit. No two states are the same so no one-size-fits-all solution will provide the help our country needs to create the excellent, sustainable, and affordable healthcare system Mary Brainerd referred to in her remarks.
Replace or Repair?
Both participants were clear that the ACA had fundamental problems, many of which created a negative impact on employers. The difference in their views appeared to be that Rep. Paulsen felt replacement was necessary while Ms. Brainerd argued for making repairs on the existing law. Ms. Brainerd also reminded the attendees that the “real ‘silver bullet’ is what we all do as a community to change our collective health behaviors.”
The next steps for any kind of national health care program are unclear. For the time being, the ACA remains the law of the land. Employers should work closely with a qualified insurance broker to ensure that they are compliant – now and in the near future – and that they are doing only what is necessary to fulfill their obligations, according to the law.