ACA Reform Ideas That Just Got More Popular

Written by Jessica Adkins

March 28, 2017

ACA Reform Ideas That Just Got More Popular!

Now that the American Health Care Act bill, proposed by Paul Ryan and the House GOP, appears to be dead, other ACA reform proposals are getting more attention. However, any reform or replacement plan will need to be introduced and implemented quickly to make some health coverage available to the consumers in 2018, as carriers are developing filings for 2018 products now based on the original ACA.

Even insurance carriers are willing to overlook the reality that making a profit in the under 65 market has been difficult since January 2014. Carriers have experienced difficulty in knowing how to sell sustainable coverage in 2018 without knowing the support programs or basic market rules.

Idea #1 – Ask Seema Verma.

Tom Bulleit, a Washington-based partner at Ropes & Gray LLP, says in a written commentary about the cancellation of the AHCA bill vote that one obvious outcome could be a bigger role for the U.S. Department of Health and Human Services, and the new HHS secretary, Tom Price.

Price “may undertake larger administrative efforts to roll back Affordable Care Act rules,” Bulleit says.

One example is the ACA essential health benefits package, or requirement for an individual or small-group major medical plan to cover at least 60% of the actuarial value of a standardized benefit package that includes the ten essential health benefits (i.e., preventative services, ambulatory, mental health & substance abuse, maternity, etc.)

Many Republicans would like to eliminate the Essential Health Benefits Package mandate. Bulleit says, “Instead of repealing the ten essential health benefits, HHS could issue new rules narrowing their definition, which might do a better job of threading the needle between moderates and conversations.”

Seema Verma, the new administrator of the Centers for Medicare & Medicaid Services, the HHS arm directly in charge of ACA commercial health insurance programs, such as HealthCare.gov, is famous for being the woman who figured out how to build health reimbursement arrangements into Medicaid coverage for moderately low-income adults. She also owned a consulting firm that has worked closely with private insurers and actuarial firms for years, and her firm had the contract to train Indiana’s navigators how to enroll people in coverage through HealthCare.gov.

Verma has openly stated she is ready to learn more about how the individual health insurance market is working by talking to insurance agents and brokers: The Baton Rouge, Louisiana-based Health Agents for America reports that Verma’s office is trying to bring HAFA agents in for a meeting.

#2 Repeal the ACA.

The AHCA bill called it a repeal effort, however, the piece of legislation was indeed designed to change ACA budget provisions. The drafters wrote it because Republicans hold 52 seats in the Senate, and a budget measure can get through the Senate with just 41 votes, rather than the 60 typically needed to push a bill onto the Senate floor.

However, other members of Congress have already introduced what is defined as an “ACA Repeal Bill.”

Rep. Steve King, R-Iowa, introduced H.R. 175 – ‘The ObamaCare Repeal Act” bill—which would just repeal the Patient Protection and Affordable Care of 2010 and the health provisions of the Health Care and Education Reconciliation Act of 2010.

Rep. Bill Flores, R-Texas, introduced a slightly longer bill, H.R. 370. This bill would repeal PPACA and the health care portions of the HCERA, and it would exempt ACA repeal from the general federal budget impact reduction requirements.

Idea #3 – Cover Everyone.

Sen. Bernie Sanders, D-Vermont, has been able to use his personal popularity to build support for the concept nationwide.

Now more than ever we need to recognize that health care is a right,” Sanders tweeted yesterday. “People who cannot afford health care do not deserve to die.”

He has returned to his campaign proposal to sponsor a single-payer option and intended to introduce legislation outlining a “Medicare-for-all, single-payer” health care plan, and he says he will reach out to President Trump to help advance it.

Ideally, where we should be going is to join the rest of the industrialized world and guarantee health care to all people as a right,” Sanders said. “That is why I am going to introduce a Medicare-for-all, single-payer program.”

Sanders has acknowledged multiple times “Obamacare has serious problems.” “Deductibles are too high,” Sanders said. “Premiums are too high. The cost of health care is going up at a much faster rate than it should.

Additionally, on Monday, Rep. Keith Ellison, D-Michigan, and deputy chairmen of the Democratic National Committee said that members of his party “stand ready” to work alongside Republicans on healthcare, includes on issues such as lower prescription drug prices.

California Democrats (aided by grassroots organization Our Revolution, a by-product of the Sanders’ campaign) are advocating for a similar bill that would launch a statewide single-payer healthcare system.

Idea #4 – Crossing Party Lines.

In Colorado, the state where a single-payer ballot measure crashed and burned, at least two Democrats have talked openly about the need for Democrats and Republicans to work together to improve the ACA.

Rep. Diana DeGette and Rep. Jared Polis, both D-Colorado, have called for bipartisan action. Meanwhile, Sen. Susan Collins R-Maine, and Sen. Bill Cassidy, D-Louisiana, are reminding everyone about their ACA change proposal, The Patient Freedom Act of 2017 bill. Their proposal would allow each state to choose whether to stick with ACA framework or shift to more a more flexible option, giving power back to the states.

“The PFA takes power from Washington and returns it to state capitols and individuals,” Cassidy says in a statement about the proposal presented earlier this year.

To find out all of the most recent updates regarding proposals, news and updates from the insurance carriers, contact our ACA Experts at 800-962-4693 for more information.

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