In recent months, much attention has been focused on Congress and whether lawmakers would vote to fund premium discounts for people who get their health insurance coverage through the Affordable Care Act Marketplace.
But health care costs are increasing for everyone, from those paying higher Marketplace premiums, to those covered by state or private insurance, to those who choose to forgo insurance entirely.
Along with higher premiums, West Virginians and people around the country are facing steeper costs for health care, from prescriptions to health checkups.
And there are ways West Virginia’s state representatives can make health care more affordable for their constituents.
Here are five ways lawmakers could help rein in higher costs.
Improve price transparency
The Trump administration has been pushing for more price transparency by requiring insurers and hospitals to make public the costs patients will have to pay for services, before patients make decisions about which plans to choose and hospitals to visit.
State officials could go further.
Researchers at Georgetown University note that states have authority over enforcing price transparency laws when providers like hospitals are noncompliant. They could collect state-level penalties from providers that don’t comply.
The West Virginia Center on Budget and Policy also recommends such efforts should be more widespread and require all health care providers to post upfront costs.
Set penalties for health care providers’ cost increases
West Virginia can establish a commission or task existing agencies with tracking whether health care provider costs are increasing faster than inflation and penalize providers for exceeding preestablished benchmarks.
The Center on American Progress notes that such programs can be effective, and states can learn from the multiple states that have already taken this step.
And to prevent providers from restricting services to avoid penalties, states could also help providers develop plans to combat the increases, including tracking spending on cost-effective preventative care.
The Center noted that in Massachusetts and Oregon, requirements to pay fines or develop these plans “helps incentivize health care entities to put in their best effort to meet targets and take these initiatives seriously.”
Help low-income patients
Federal law requires nonprofit hospitals to provide free care or financial assistance paying bills for low-income people.
The Commonwealth Fund suggests states like West Virginia could help more people access charity care — free care based on their income — by streamlining the sometimes confusing and lengthy application process and hiring people to help patients navigate it.
In Minnesota, hospitals are required to schedule patients’ appointments with these application counselors.
The Commonwealth Fund noted that in Oregon, nonprofit hospitals must preemptively screen patients for eligibility if they are uninsured or owe more than $500.
Stop the consolidations
Hospital consolidations lead to higher prices because they reduce competition.
West Virginia could limit further consolidation, although most providers in the state are already consolidated under either the WVU Medicine or Vandalia Health umbrellas.
The West Virginia Center on Budget and Policy notes that the federal government can already limit hospital consolidation.
But it adds that many consolidations escape review, so state attorneys general can fill in the gaps.
The Rhode Island attorney general has blocked mergers because it predicted they would decrease competition and announced a proposal to require 60-day pre-merger notification, giving the office time for a thorough review.
Create a public option
Lawmakers could create a public health insurance program, like Medicaid, but through which higher-income adults could purchase coverage.
These plans bring down costs by increasing competition and preventing some people — such as those who’ve now lost their ACA plans or decided to go without insurance — from going without any coverage.
And if the price of health care dropped due to the additional option, companies could switch from spending on employee health care to paying higher wages, according to a report from the University of California, Berkeley School of Law’s Center on Health, Economic & Family Security.
Such a program would be government-funded. But it would increase state revenues by decreasing employer spending on health care benefits, which aren’t taxed, while increased wages would be.