Kaiser Chief to Congress: You Have Just Days to Save Individual Health

Bernard Tyson, the head of one of the biggest U.S. health insurers, told the Senate on Tuesday that Congress must act quickly if it wants to keep the individual health insurance market stable in 2018.

Congress has just days to provide meaningful relief for 2018, not weeks, Tyson said in written hearing testimony.

In oral testimony, Tyson said Congress and private industry players need to work together to shore up the individual market.

“We own the success or the failure of the American health care system together,” Tyson said. “It’s not about the government, or the marketplace, it’s about both of us working together.”

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Tyson is the chief executive officer of Oakland, California-based Kaiser Foundation Health Plan Inc.

4 Senate HELP Hearings

Tyson appeared at the third in a series of four hearings organized by the Senate Health, Education, Labor and Pensions Committee on stabilizing the individual health market.

The committee has streamed all of the hearings, including the third one, live on the web, and it has posted a video recording of the hearing, and the written versions of the witnesses’ testimony, here.

The first hearing featured state insurance commissioners, and the second hearing featured governors.

The fourth hearing, set for 10 a.m. Thursday, will feature a variety of “health care stakeholders,” including Raymond Farmer, South Carolina’s insurance commissioner, and Robert Ruiz-Moss, an Anthem individual health insurance unit executive.

The Tyson Plan

Tyson asked senators at the hearing on Tuesday to remember that, whatever faults the current Affordable Care Act system has, the system that existed before the ACA came along also had serious faults. 

“Before the ACA, many millions of Americans were unable to buy coverage or were priced out of coverage because of pre-existing medical conditions,” Tyson said in the written version of his testimony. “Virtually no one wants to go back to the way it worked before; we certainly don’t.”

Tyson encouraged senators to adopt changes that insurance commissioners and governors had backed in the Senate HELP hearings held last week:

• Keeping up funding for the ACA cost-sharing reduction subsidy system, which helps low-income exchange plan users pay their deductibles, co-payments and coinsurance amounts.

• Funding a reinsurance program, to buffer health insurers against the effects of insuring people with catastrophic claims.

• Enforcing the ACA requirement that many individuals own what the government classifies as “minimum essential coverage,” or solid major medical coverage.

• Support individual major medical insurance and ACA public health insurance exchange marketing and enrollment support efforts.

Brokers “have a significant role to play in helping to encourage enrollment,” Tyson said, but he said coverage issuers also need help from navigators and other nonprofit assisters with reaching some hard-to-reach populations, such as people who speak certain languages that few brokers speak.