Several Democratic lawmakers recently called on the Trump administration not to move forward with a last-minute proposal allowing states to privatize their Affordable Care Act exchanges.
Democratic leaders of key healthcare committees in the Senate and House wrote to CMS, HHS and Treasury Department on Dec. 30, saying consumers will pay higher premiums for less comprehensive coverage if private brokers are in charge of state-based exchanges. That would also result in more people not having insurance coverage, the lawmakers said. The Trump administration could issue the final rule before leaving office.
"Eliminating a centralized enrollment pathway for consumers would leave millions of Americans uninsured or underinsured, obstructing their access to healthcare and leaving them vulnerable to financial ruin in the middle of an unprecedented public health and economic crisis," the letter said.
Reps. Richard Neal (D-Mass.), Frank Pallone Jr. (D-N.J.), Bobby Scott (D-Va.) and Sens. Ron Wyden (D-Ore.) and Patty Murray (D-Wash.) urged the federal agencies to wait until the Biden administration takes office before making any major policy decisions.
CMS recently granted Georgia an exemption from the Obamacare marketplace so it can create a decentralized system of web brokers and insurers through which consumers can buy insurance. CMS said the move would encourage competition among insurers and decrease premium prices for consumers, thereby lowering healthcare spending.
But the Democratic congressional leaders worry companies will not alert consumers if they're eligible for Medicaid or the Children's Health Insurance Program. The plan to allow insurance companies to delay translating their webpages will also result in a disproportionate number of non-native English speakers without coverage, the letter said.
CMS's recently revised methodology for calculating how premium subsidies are doled out has already raised prices and increased the annual limit on total out-of-pocket expenses for enrollees in marketplace and employer-sponsored plans. A family of four earning $80,000 per year can expect a $360 annual premium increase, the letter said. Under the new rule, the lawmakers said private insurers will refer unknowing individuals to short-term plans or junk insurance, resulting in even higher premiums and substandard care.
"This proposal threatens to further exacerbate underlying racial and ethnic disparities in health coverage, outcomes, and access, particularly among immigrants who currently have lower rates of health insurance, use less healthcare, and receive lower quality care than U.S.-born populations," the letter said.