America's Health Insurance Plans, the insurance industry's largest lobbying group, urged the Senate this week to take steps quickly to stabilize the individual insurance market and ensure that Medicaid is adequately funded.
In the letter addressed to Utah Republican Sen. Orrin Hatch, who chairs the Senate Finance Committee, AHIP President Marilyn Tavenner reiterated health insurers' need for certainty surrounding the future of the individual market as they determine their 2018 rates. The federal deadline to submit those rates is less than a month away.
Tavenner urged the Senate to fund the cost-sharing reduction subsidies that help low-income consumers afford coverage on the Affordable Care Act's health insurance exchanges, noting that uncertainty regarding cost-sharing reduction subsidy funding would cause insurers to raise premiums by 15% to 20% while also reducing plan choices for consumers.
"It cannot be overemphasized that, as changes and reforms to the individual market are considered as part of a broader package, the timeline is extremely short to advance these crucial steps to improve stability and affordability for consumers in the individual market and have a positive impact on 2018 premiums," the letter said.
Tavenner also expressed concern that Medicaid reforms included in the GOP's American Health Care Act would result in "unnecessary disruptions in the coverage and care beneficiaries depend on." For example, she wrote, insufficient funding could jeopardize the progress health insurance plans are making in providing access to opioid abuse treatment.
AHIP's letter is dated a day before the Congressional Budget Office released its updated score of the GOP bill, the American Health Care Act, which the CBO concluded would leave 23 million more people uninsured by 2026 than under the ACA, while saving the federal government $119 billion.
Groups representing hospitals and physicians responded to the CBO score with statements criticizing the AHCA for jeopardizing coverage for millions and threatening healthcare access to low-income families on Medicaid.
AHIP did not comment specifically on the CBO score. The AHCA is now being considered in the Senate, having narrowly passed the House this month before the CBO analyzed the legislation with its additional amendments.
In the letter, AHIP praised the repeal-and-replace for including provisions to stabilize the individual insurance market, such as creating the $100 billion "patient and state stability fund," enhancing tax credits for younger enrollees, eliminating taxes on health insurers and promoting continuous coverage through premium surcharges. AHIP urged the Senate to maintain these provisions as it debates the legislation.
Legislators should enhance the premium tax credits included in the AHCA, AHIP said. As the bill currently stands, the AHCA's tax credits put a heavier financial burden on older, low-income enrollees than under the ACA.
On the Medicaid front, AHIP recommended the Senate ensure states have more flexibility to run their own programs for their unique members. The lobbying group said legislators must provide a stable transition period to the reformed individual market and Medicaid program.
"This will promote public confidence and allow adequate time for stakeholders (e.g., states) to make adjustments, encourage participation in the market, and increase health care access and financial security," the letter stated.