{Guest blog} Health care reform – where do we go from here?

We know that many of our members have questions about the current state of health care reform in our country. While the future is still uncertain, we want you to know that we are working with our elected federal officials, as well as our state lawmakers and regulators, to ensure that Kansans have access to high-quality health care at a price they can afford. We invited BCBSKS Director of Government Relations Sunee Mickle to provide an update on how things are progressing in Washington, D.C.

When my colleagues and I first started discussing the idea for this blog post, we felt that by mid-April there would be some clarity as to the future direction of health care reform in the United States. At that time, the Republicans appeared to be gaining momentum to pass a piece of legislation that would be the first of three phases in replacing the Affordable Care Act (ACA).

As you might recall seeing in the news in early April, no vote was taken on the proposed reconciliation bill known as the American Health Care Act because Republican leadership in the House recognized that factions of their own party had not come together to support the plan.

So where do we go from here?

While House leadership has indicated its desire to move on to other topics in the months ahead, such as tax reform, President Trump has indicated a willingness to continue discussions with the various factions within the Republican party, as well as interested Democrats, to improve our country’s health insurance system. He has committed to help stabilize all sectors of the insurance market beginning in 2017 to encourage insurers to participate on the individual exchange and other market segments during the 2018 plan year.

President Trump also could consider additional administrative action. You might recall on the evening of his inauguration, President Trump signed an executive order to minimize the financial burdens the ACA places on individuals, businesses, insurers and providers. This allows regulatory agencies to exempt businesses and individuals from financial burdens such as regulations and mandates to purchase coverage.

Tom Price, the Department of Health and Human Services secretary, has initiated several administrative actions to assist the insurance industry and create more coverage options for consumers. The most significant changes include amending the individual market open enrollment period for 2018 to begin on Nov. 1, 2017, and end six weeks later on Dec. 15.  In addition, insurers will be able to charge individuals for unpaid premiums before re-enrolling them in coverage in 2018. This may help encourage continuous coverage in the market and reduce adverse selection from individuals who use the 90-day grace periods to avoid paying insurance premiums.

One of the most important responsibilities that I perform on behalf of Blue Cross and Blue Shield of Kansas members is to help elected officials in both Washington, D.C., and Topeka understand how proposed legislation might impact – positively or negatively –  our members and Kansas businesses that purchase insurance for their employees. It is important that we share facts and information with these elected officials so they may craft legislation that will work for all Kansans.

As discussions continue in Washington, D.C., here are the key points that I’m making:

  • Kansas needs a competitive, private health insurance market that works for Kansans and offers them choices. Premiums must be more affordable so as many people as possible may purchase coverage, giving them the peace of mind that comes with carrying health insurance.
  • Insurers and our members need certainty about continued funding for the cost-sharing reductions that help thousands of Kansans manage their out-of-pocket costs by providing financial assistance for deductibles and copays. This assistance has been built into their benefits plan in the past and it would be disruptive to remove it abruptly.
  • In order to have an insurance system in which everyone can obtain coverage regardless of their medical condition, there must be a way to pay for the cost of caring for those with significant medical needs.
  • We need to take strong measures to ensure that people stay covered year-round, not only so they can get the care they need, but so costs are kept in check and spread equitably.
  • We support returning authority and flexibility to the states because states best understand local health care systems and their communities’ specific needs. State officials, particularly those at the Kansas Insurance Department, are in the best position to protect consumers and ensure that insurance plans that are offered meet the needs of Kansans.

Although 2018 is still many months away, BCBSKS is preparing to soon file our 2018 individual and small group health insurance products. I know our elected officials in Washington, D.C. understand our timeline and the need to act carefully and quickly to restore stability to the individual health insurance market. I am hopeful we will begin to see positive changes that will help BCBSKS offer health insurance products that best meet the needs of Kansans in 2018.

Sunee Mickle, BCBSKS Director of Government Relations

One thought on “{Guest blog} Health care reform – where do we go from here?

  1. We don’t want state option for a waiver of pre-existing conditions or essential health benefits.
    1. It hurts us as employers — we’ve had employees with pre-existing conditions, and we will get hit financially with a higher premium for that employee, and if it is too expensive, we have to pass on a higher amount to them, which they can’t pay so they don’t have health insurance.
    2. It hurts us as health care providers — they become under-insured and they don’t get immunizations or well-checks because it costs them a proportion or they have to be cash-pay, Aside from affecting our bottom line, it’s goes back to being sick care not health care.

Leave a Reply