America’s Health Insurance Plans’ National Policy Conference last week emphasized health care and coverage equity throughout the presentations and discussion. Presenters also tackled some of the big health-related issues of the day, from social determinants of health to price transparency. Here are some takeaways.
Relief over rescission of the 2019 public charge rule
Katie Keith, an adjunct law professor at Georgetown University and a principal at Keith Policy Solutions, called the Biden administration’s revocation of the 2019 public charge rule last week good news for health equity.
The US Supreme Court also dismissed a case related to the rule, which was implemented by the Trump administration. The rule told immigration authorities to refuse to grant green cards and visas to applicants likely to need public programs, such as Medicaid, the Supplemental Nutrition Assistance Program or housing assistance.
“This rule, I think has contributed to significant depression in enrollment among folks who are eligible for all kinds of benefits … so I think it’s a relief to many that the rule is no longer going to be heard by the Supreme Court,” Keith said.
Asian and Pacific Islander American Health Forum CEO Juliet Choi said the rule had resulted in fewer immigrants accessing basic health care due to intimidation and fear, and the challenge going forward will be sharing a different message with these groups.
“Sharing that messaging that yes, immigrants can once again can access public benefits, including health care, that they are eligible for,” Choi said.
BCBS North Carolina takes health care beyond traditional boundaries
Blue Cross and Blue Shield of North Carolina CEO Dr. Tunde Sotunde said providing health care beyond traditional boundaries — to encompass physical and emotional health and social determinants of health — had been the insurer’s mission before the COVID-19 pandemic, but it became even more important as the crisis escalated.
“We’ve been focused not only on addressing or ensuring the health, safety and welfare for our workforce, but doing it in such a manner that makes sure that we are continuing to meet the needs of our consumers, our customers, our employer group partners, our health care professional partners,” Sotunde said. “And then also, most importantly, supporting the needs of the communities in which we all live and work, which by the way, whose needs have manifested even more so as a result of the pandemic.”
The insurer expanded telehealth and virtual visits and eliminated out-of-pocket costs for COVID-19 and related illnesses. It has helped community organizations address SDOH. In 2020 it sent $200 million in health and wellness cards to more than 600,000 subscribers for food, over-the-counter medicine and other health-related items. It has provided about $20 million in funding so far to about 500 of its independent primary care practices to help them remain viable during the pandemic. It obtained equipment to manufacture personal protective equipment from China, and it has a goal of delivering 1 million N95 masks for health care workers.
ACA marketplaces see opportunity in American Rescue Plan Act
When President Biden signed into law the American Rescue Plan Act of 2021 last week, it opened up new opportunities for Affordable Care Act marketplaces to expand coverage access.
“This is the first time, with the American Rescue Act, that we’re actually looking at building on and not just defending the Affordable Care Act,” said Peter Lee, executive director of Covered California.
Lee said millions of Americans nationally, including 15 million who aren’t enrolled in ACA marketplace coverage and 9 million who are, could benefit from the new law, which temporarily extends and increases subsidies for ACA plans.
The Congressional Budget Office predicted marketplaces would only be able to enroll about 10% of people eligible for subsidies, Lee said, but added those estimates will not hold up if exchanges “do a decent job” of outreach.
Lee said exchanges should consider very long special enrollment periods and, from a marketing perspective, treat them like open enrollment.
Kevin Patterson, CEO of Connect for Health Colorado, said increasing eligibility for subsidies to those earning above 400% of poverty will make a big difference in Colorado’s rural and resort communities. The exchange is working to be ready to quickly respond to an influx of new enrollees.
“For us, it’s around how do we turn this marketplace around, balance our technology and try to create this mid-year change for a lot of new enrollees,” Patterson said.
Price transparency is here to stay
A new rule on health care price transparency is here to stay, but it is not perfect, and it will take time to develop comparison data, according to James Capretta of the American Enterprise Institute and Debbie Harrison of the Business Group on Health.
Capretta said even though price transparency was a Trump administration action, it is not likely that the Biden administration will get rid of it and could even add provisions. It will be important for the government to develop a structure for providers to use when disclosing prices to make it easier for people to make comparisons. Capretta said consumers also may need some financial incentives for doing comparison shopping.
Harrison said employers support transparency, but implementation must be done in an organized way to make the information useful for determining price and quality. Information provided early on may not be robust enough to make good comparisons.
“I think it will be a period of years before we can actually build up a data system that is accurate, consistent, usable,” Harrison said. “Once that happens, I think that actually will shed a lot of light on where there are inefficiencies in the system and allow people to develop policies to move forward and hopefully get better quality and lower-priced care.”
Ellen Beck is a staff writer and editor who specializes in health care and wellness. She has been a journalist for more than 30 years for print, wire service and online publications, and in radio news.
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