Democrats convene this week at their national convention in Philadelphia on the heels of last week’s Republican gathering in Cleveland, and while no issue divides the parties as starkly as healthcare, they agree that states should take a leading role in healthcare reform.
The Democrats' platform pledges to “empower the states” to use the Affordable Care Act’s Section 1332 “innovation waivers.” Starting in 2017, these waivers can – if approved by federal regulators – exempt states from one or more key ACA reforms such as the employer mandate, individual mandate, or public health insurance exchanges. The waiver lets a state tailor its own health reform initiative, provided it doesn't reduce the number of insured individuals and adheres to certain other restrictions. States that secure waivers receive federal funds that otherwise would have been spent on public exchange subsidies. Colorado and New York, for example, are considering proposals to pursue waivers to launch single-payer healthcare initiatives.
Other items in the Democratic platform call for allowing people to buy into Medicare starting at age 55, reducing prescription drug costs, capping consumers’ out-of-pocket costs, creating a public insurance plan option, and giving states new incentives for Medicaid expansion.
While the Republican platform calls for repeal of the ACA, it urges restoration of states’ “historic role” as regulators of health insurance and limited federal involvement. The platform also contains several familiar themes including broader distribution of tax breaks for the purchase of healthcare, greater price transparency, and purchasing pools for small businesses and individuals.
The party platforms are more wish lists than to-do lists for a new administration, but they provide key messaging points ahead of the elections and will help frame the policy debate next year.
Before leaving for the conventions, Congress left behind a number of bills with implications for employer health care plans. Lawmakers return after Labor Day for a brief work period before leaving again to campaign ahead of the November election. Certain proposals with bipartisan backing could cross the finish line this year as part of larger tax or spending bills, but most bills, such as one liberalizing HSA rules, face dim prospects.