One of the most deeply experienced insurance policymakers in the world says the best hope for fixing the U.S. health insurance system lies in private conversations between members of Congress.
Ben Nelson is a former insurance company chief executive officer, a former Nebraska insurance director, a former Nebraska governor, a former U.S. senator and a former executive director of the National Association of Insurance Commissioners.
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Nelson talked about what he sees as an urgent need for informal lawmaker conversations Sunday, during a panel discussion in Washington, at a meeting of the National Governors Association. The NGA put Nelson on a panel about “negotiating a health care solution.”
Nelson, a moderate Democrat who was served in the Senate when the bills that created the Affordable Care Act were being debated, and who cast some of the votes that let the act come to life, said lawmakers who really want to improve the health insurance situation need to be talking informally.
“It seems to be a lot safer to do things informally right now,” Nelson said.
Lawmakers who want to try to change the ACA through formal channels, because of the problems the current ACA system clearly has, have to go home to face the wrath of crowds of people who are terrified that any efforts to change the ACA system mean full ACA repeal, Nelson said.
Nelson is now a partner at Heartland Strategy Group, an Omaha, Nebraska-based lobbying firm. He said the root of the problem with changing the ACA is that the unpopular parts pay for the popular parts.
Would-be ACA changers “don’t know what they can get rid of to save any money,” Nelson said.
One key to keeping a health insurance system stable is finding some way to make coverage nearly universal, to make sure the healthy people are in the system along with the people who are expensive to cover, Nelson said.
Haley Barbour, another panelist, agreed with Nelson that changing the ACA will be difficult.
In this video, Ben Nelson, Haley Barbour and other panelists talk about the politics of Affordable Care Act change. (Video: National Governors Association/YouTube)