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May 19, 2020 03:38 PM

Employer groups ask Congress to provide COBRA subsidies, bolster primary care

Shelby Livingston
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    A group of 36 organizations representing U.S. employers on Tuesday urged Congressional leaders to bolster job-based health coverage and access to healthcare services by providing COBRA subsidies, shoring up primary care practices and implementing programs to mitigate potential premium hikes.

    The joint letter outlined recommendations for policies to be included in the fifth COVID-19 relief package, which has been passed by the House of Representatives but is stalled in the Senate. The American Benefits Council, The ERISA Industry Committee, the National Alliance of Healthcare Purchaser Coalitions, and the Pacific Business Group on Health drafted the letter.

    "The COVID-19 crisis has exposed the pre-existing failures of our healthcare system and reinforced the fact that our physical and economic health are inextricably linked," PBGH president and CEO Elizabeth Mitchell said in a statement. "The current situation must be a catalyst for expediting the reforms that have been needed for years. Doing so is essential not only to ensuring the health of our citizens, but also to restoring our economy. We are urging Congress to take bold action now."

    The groups asked Congressional leaders to provide subsidies covering 90% to 100% of the cost of coverage under the Consolidated Omnibus Budget Reconciliation Act, or COBRA, for employees who have recently lost job-based coverage. Hospitals and health insurers also support COBRA subsidies.

    More than 30 million people have lost their jobs since mid-March, and a recent analysis estimates that nearly 27 million people may have lost healthcare coverage during that time.

    The employer groups further urged Congress to expand telehealth access by eliminating red-tape and allowing companies to offer telehealth as a standalone benefit to workers not enrolled in a medical plan.

    The groups also asked for support for primary care providers. They recommended that the CARES Act provider relief funds be directed to primary care physicians and practices that need help the most, and that CMS provide practices per-member, per-month payments for Medicare, Medicaid and Children's Health Insurance Program beneficiaries.

    Further, they urged Congress to mandate that healthcare providers may not merge for at least 12 months as condition of receiving CARES Act funds. Consolidation among providers has led to higher healthcare prices, countless studies have shown. The groups also asked Congress to protect against surprise billing by requiring that COVID-19 services covered without cost-sharing be paid at the Medicare rate when delivered out-of-network.

    They asked Congress to enact a reinsurance or one-sided risk-corridor program to protect insurers and employers from unexpected COVID-19 costs in 2020 and 2021. The programs would kick in only if costs exceeded a certain threshold. While COVID-19 costs may be offset by reduced utilization of elective procedures in the short-term, it's unclear what will happen once the pandemic subsides. That uncertainty could lead to premium hikes, the groups wrote.

    "Congress must act to protect the healthcare benefits of all American workers and families, during this pandemic and beyond," Annette Guarisco Fildes, president and CEO of The ERISA Industry Committee, said in a statement. "By reducing healthcare prices and expanding its value and accessibility well beyond the crisis, employers and their employees will be better protected from abusive practices, rising costs, and loss of health coverage, today and in the future."

    Correction: This story incorrectly stated that the letter to Congressional leaders was drafted by the American Business Council. The organization is called the American Benefits Council.

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