Carriers Push for PPACA Changes

healthcare reformMy Comments: I probably sound more like a broken record than someone interested in how life plays out over time. For longer than I care to remember, I’ve talked about flaws in the PPACA and yet how something like this had to appear on the scene to keep us from falling off a socio-economic cliff in a few years.

How much more helpful would it have been for there to be a bi-partisan effort to fix the flaws in the PPACA over the past 6 years than to simply attempt, over and over again, to repeal it and replace it with nothing? Talk about wasted opportunities.

The grand architect of the effort by the GOP to repeal ObamaCare has now lost his seat in the House. But not because of his efforts to repeal ObamaCare, but because in spite of his efforts, Barack Obama is still in the White House. This article reflects a rational approach from one of the five principal stakeholders in the debate to bring needed modifications to the PPACA to make it work better for all of us.

The nation’s carrier group, America’s Health Insurance Plans (AHIP), is urging the administration to add a new lower-cost plan under the exchanges — as well as a couple other changes to the Patient Protection and Affordable Care Act — “to enhance the affordability, stability and accessibility of health care.”

On Wednesday, AHIP proposed a series of changes to the law that they say could boost consumer participation in the exchanges — especially among young adults — and, overall, would improve the consumer experience.

Creating a cheaper tier of coverage — or catastrophic plans — is the central proposal for the group, which they proposed would have an actuarial value slightly lower than the current lowest bronze tier of coverage. The plans would still comply with other standards and rules under PPACA, AHIP said, including the minimum benefits standards and free preventative care, but they would be cheaper than the other offered plans.

“Such a plan would offer consumers the option of coverage that has lower monthly premiums but still provides the comfort of knowing that their costs will be limited in the event of a serious illness or injury,” AHIP’s proposal said.

Catastrophic plans are now only available to young adults under 30 and to those whose health care coverage was cancelled by the law. Offering such plans through the exchanges could entice young and healthy enrollees, AHIP said, therefore holding down premium costs. And those plans would, or should, be eligible for subsidies, further bringing down costs.

AHIP also proposed “enhancing stability by ensuring continuity of care protections to provide important support during times of transitions in coverage.” This translates to a 30-day transition period for certain individuals who have a serious illness or are pregnant, AHIP said.

The third recommendation that AHIP gave was enhancing accessibility through greater transparency, so that patients are getting the information they need to choose the right coverage, as well as the right care.

“We know that affordability, stability and accessibility are top of mind for consumers when it comes to their health care,” AHIP President and CEO Karen Ignagni said. “These solutions demonstrate health plans’ ongoing efforts to advance these key priorities, and we intend to work with all stakeholders to provide consumers with greater peace of mind in the new marketplace.”