Coverage & Access
Issue: The Patient Protection and Affordable Care Act (PPACA, P.L. 111-148), brought about the most sweeping changes to our nation’s healthcare system since the creation of Medicare in 1965. The administration, governors, payors, providers, and suppliers are preparing for 2014 when insurance exchanges will become operational and Medicaid eligibility will be expanded to up to 133 percent of the federal poverty level. The Congressional Budget Office estimates that 19 million uninsured Americans will gain coverage in 2014 and, by 2019, a total of 32 million Americans will be covered as a result of PPACA policies. Passage of PPACA was a significant step to help make health coverage more available and affordable for millions of Americans. However, the hard work of improving America’s healthcare system to ensure excellence and sustainability for the long term is only beginning.
HLC Position: Accessible, affordable health coverage remains HLC’s number one priority issue. Every American should have access to quality and affordable health coverage. HLC is committed to ensuring the continued availability of market-based, consumer-centered healthcare options, as well as a stable safety net for low-income individuals. Health coverage options offered both inside and outside of the exchanges must ensure that health coverage options are able to respond to market innovation.
HLC Health Reform and Access to Coverage Issue Paper
HLC Key Recent Activity on Health Reform and Access to Coverage:
- Based on HLC CEO interest and in preparation for the January 2012 Uninsured Task Force meeting, HLC created a Medicaid reform work group which is developing recommendations to reduce cost drivers and increase overall value.
- Through the Choice and Competition Coalition, HLC participated in Hill meetings to discuss the exchange regulations and how to assist states to ensure a federal fall-back option is avoided.
- HLC staff spoke to state legislators on ACA implementation, emphasizing the need for market-based exchanges.
- In October, HLC submitted comments to HHS on the proposed rule for establishing Health Insurance Exchanges and Qualified Health Plans. Additionally, HLC supported other coalition letters which promoted workable exchanges.
- In meetings with members of Congress, HLC continued to emphasize the importance of covering as many people as possible. HLC also emphasized the need for maximum flexibility and accessibility in health plan design to meet the diverse needs of individuals.
- In June, several HLC CEOs met with the U.S. House Republican Policy Committee to discuss PPACA and concerns with the law, including rate setting.
- Over the August recess, HLC regional directors educated members of Congress on HLC’s concerns about private insurance market stability, broad participation in insurance exchanges, and Medicaid crowd-out possibilities.
- HLC staff met with representatives from the Republican Governors Association to offer support and guidance that encourages governors to implement health insurance exchanges that promote competition and preserve consumer choice, and to avoid the federal exchange fallback under ACA.
- In an effort to educate congressional and gubernatorial staffers, HLC, as part of the Choice and Competition Coalition, cohosted two briefings on exchanges. The briefings stressed the importance of ensuring that health insurance exchanges promote competition and preserve consumer choice.
- In meetings with members of Congress, HLC continued to emphasize the importance of covering as many people as possible. HLC also emphasized the need for maximum flexibility and accessibility in plan design to meet the diverse needs of individuals.
- HLC staff met with representatives from the Republican Governors Association to offer support and guidance that encourages governors to implement health insurance exchanges that promote competition and preserve consumer choice, and to avoid the federal exchange fallback under ACA.
- HLC participates in the Choice and Competition Coalition, a partnership of businesses, providers, brokers, insurers, and other groups. Its mission is to educate key policymakers on the importance of assuring consumers’ access and choice when purchasing healthcare coverage by providing guidance on federal regulations regarding the creation of exchanges. Additionally, HLC is monitoring states’ progress on their various activities surrounding the creation of exchanges.
- The HLC Policy Committee hosted Stan Dorn of the Urban Institute to discuss health insurance exchange implementation and best practices for maximizing enrollment.
- HLC staff continues to serve on the Health Care Industry Access Initiative Board. The initiative is a non-profit organization dedicated to promoting collaborative action across the healthcare industry to improve access to health coverage.
- HLC continues to provide informal guidance to and monitor Enroll America campaign. Enroll America is a 501(c)(3) organization created to facilitate effective state-based and national health coverage enrollment efforts. At a recent Enroll America meeting, HLC presented a report on HLC’s lessons learned about enrollment from its Health Access America and Medicare Today campaigns.
- HLC participates on the board of the Council for Affordable Health Coverage (CAHC) and continues to provide all administrative support to the coalition.
- HLC continues to participate in CMS’s National Partnership Field Strategy group to disseminate information about health reform implementation.