Virginia: Gov. Northam does the right thing, vetoes bills which would undermine the ACA

Virginia Governor Ralph Northam has been out of the national news for the past month or so, keeping a low profile since the media frenzy over the "med school blackface photo" debacle subsided. Rightly or wrongly, in the end, in spite of pretty much everyone under the sun demanding that he resign, he stuck it out and outlasted the scandal by simply...not.

He isn't up for reelection (and in fact under Virginia law he can't run again anyway), he didn't actually commit any crimes or anything else impeachable, so it sounds like the state has pretty much just sort of accepted that he's gonna stick it out for another couple of years. In fact, according to this article in the Virginian-Pilot, he seems to have regained some of his pre-scandal stature:

Two months after a blackface photo in an old yearbook nearly ended the political career of Virginia Gov. Ralph Northam, his life seems mostly back to normal.

The Democratic governor is cracking jokes at almost daily public appearances around Virginia. State lawmakers who called on him to resign are now all smiles, standing beside him at news conferences. The Twitter mob has moved on to other things, and the antifa-led protests outside his house have stopped.

At a century-old black church in Richmond over the weekend, Northam was warmly received as he helped unveil a historic marker for civil rights matriarch Dorothy Height.

Violet Robinson, a retired educator who is African-American, gave the governor a big hug after meeting him for the first time.

"I love him and he's true and I believe in him and I trust him," she said.

It's a remarkable turnabout, just two months since Northam was nearly driven out of office. And it highlights the volatility of politics today, with new scandals sprouting constantly, only to be forgotten when some other reason for outrage arises.

My personal take at the time was that he should probably step down, not just because of the incident itself (it happened when he was a mid-20's medical student, not as a teenager), but because his initial response to it was so bizarre and confusing that it seemed like he simply wouldn't be capable of carrying out his duties as governor. Obviously he managed to straighten that out.

In any event, last May Northam vetoed four GOP-sponsored healthcare-related bills which, had they become law, would have further fragmented Virginia's ACA-compliant individual market, causing further premium increases and exposing thousands of people to swiss cheese-style coverage.

Well, it looks like pretty much the same thing just happened again last week:

Governor Northam Vetoes Legislation That Would Undermine Efforts to Ensure Access to Quality, Affordable Health Care

RICHMOND—Governor Northam today vetoed House Bill 2260 and Senate Bills 1027, 1240 and 1674, which would put Virginians at risk of being underinsured, result in rapidly increasing Marketplace premiums, and undermine key protections in the Affordable Care Act.

The Governor’s full veto statements are below.

Pursuant to Article V, Section 6, of the Constitution of Virginia, I veto House Bill 2260, which would direct the Commissioner of Insurance to request federal permission for insurance carriers to offer catastrophic plans to all individuals purchasing coverage through the Marketplace.

This legislation would place consumers at risk of being underinsured and would fragment Virginia’s federal marketplace risk pool, leading to rapidly increasing premiums. House Bill 2260 would allow insurance carriers and individuals to circumvent the protections in the Affordable Care Act. Under current law, catastrophic plans are only available for individuals who are younger than 30 years of age and individuals who qualify for a hardship or affordability exemption. Catastrophic plans typically have lower premiums because they require individuals to meet very high deductibles before the plan pays for health care costs. Many individuals enrolled in a catastrophic health plan may forego medical services because of cost. Individuals with minimal health care needs are more likely to purchase these threadbare plans, leaving individuals with more complex medical conditions in traditional marketplace plans. This adverse selection would likely contribute to an increase in Virginia marketplace premiums across the board.

Virginia took a positive step to increase the availability of quality, affordable, and comprehensive health care coverage through Medicaid expansion for individuals whose income is lower than 138% of the Federal Poverty Line. Our responsibility is now to look at solutions such as those proposed by the Market Stability Workgroup in order to improve affordability across the Commonwealth’s health insurance markets. House Bill 2260 would undermine those efforts.

Accordingly, I veto this bill.

(Senate Bill 1027 appears to be identical to House Bill 2260; he vetoed both)

Pursuant to Article V, Section 6, of the Constitution of Virginia, I veto Senate Bill 1240. This bill would authorize health insurance carriers in the Commonwealth to offer short-term, limited-duration health plans that last up to 12 months and are renewable for up to 36 months.

This legislation undermines an individual’s right to quality, affordable, and comprehensive health care coverage. This would result in many Virginians being underinsured. Short-term, limited-duration plans are allowed to discriminate against individuals with pre-existing conditions, impose lifetime and annual caps, and are not required to provide essential health benefits. A typical short-term policy does not cover maternity care, prescription drugs, or mental health care. Additionally, individuals shifting out of their respective markets into short-term, limited-duration plans are expected to be healthier than average, fueling adverse selection that would increase premiums, negatively impact insurer competition, and destabilize the individual market.

Pursuant to Article V, Section 6, of the Constitution of Virginia, I veto Senate Bill 1674. This bill would authorize health insurance carriers in the Commonwealth that offer short-term, limited-duration health plans to offer a guaranteed option for a covered individual to purchase a new plan at a future date without re-underwriting.

As an aside, for any state which does insist on allowing short-term, limited duration plans to last a full year and be renewable for upto 3 years, at the very least could you change the damned name to something besides "short term, limited duration" since they're no longer either one?

Sheesh.

Whatever else you may think of Gov. Northam, he did the right thing in (again) vetoing these bills. The solution to the ACA's woes isn't to further slice up the risk pool (and Virginia already did that once last year with the passage of the "TinyGroup Law", which I had very mixed feelings about but was the result of an extreme situation), but to remove the 400% FPL subsidy cap and beef up the APTC formula.

Anyway, as a reminder, here's my explainer video on how #ShortAssPlans negatively impact the ACA individual market: