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Bipartisan healthcare efforts hit snag over state flexibility disagreements

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Bipartisan healthcare efforts hit snag over state flexibility disagreements

Bipartisan healthcare efforts hit snag over state flexibility disagreements September 18, 2017

As the debate over the Affordable Care Act (ACA) continues and the deadline for changes to 2018 market plans looms, there are still a number of issues to be resolved. The Senate health committee met recently with a goal of stabilizing ACA, given the reality that the healthcare plan would not be repealed and replaced soon.

The deadline for insurers to decide if they would offer healthcare coverage in the form of individual plans in 2018 – and what the premiums would be for those plans – is September 27. One issue is the discussion around cost-sharing reductions, impacting lower-income individuals. As reported in Modern Healthcare, if there is no firm agreement on CSR payments, “insurers are expected to raise rates in some areas by more than 20%, or stop offering coverage on the exchanges entirely.”

The senior Republican and the senior Democrat on the health committee disagreed as to how much flexibility to give individual states “to redesign the ACA’s coverage requirements under state innovation waivers.” While there appeared to be a consensus that Congress should “swiftly fund payments” to subsidize healthcare for low-income individuals, the snag over state flexibility could “doom prospects for passage of a stabilization package” before the deadline.

Concerns arose during the health committee meeting that giving states the flexibility to change their plan benefit categories could result in higher healthcare costs for individuals. A disagreement among the committee members focused on whether states should be allowed to strip down the ACA benefit requirements so they can sell cheaper healthcare plans. Some argued that that would allow individuals to customize their plan while others disagreed, saying it would simply result in less available coverage.

Elation Health will monitor and report on the latest news in the ACA debate as it happens. At Elation, we are focused on helping independent physicians provide the highest quality care to their patients and to be successful in their practices. We continue to be dedicated to bridging the enormous chasm between the world of policy and payers, and the world of the front-line physician.