Health care industry groups back ObamaCare reforms proposed by Democrats

Powerful interests in the health care industry united behind a set of proposals Wednesday they argued would achieve universal insurance coverage, an apparent endorsement of similar plans offered by congressional Democrats and President Biden to build on the Affordable Care Act (ACA).

Groups representing health insurance plans, doctors, hospitals and businesses endorsed policies favored by Democrats that would expand financial assistance to consumers to cover premium costs for ACA plans and incentivize states to expand Medicaid to more low-income adults.

“While we sometimes disagree on important issues in health care, we are in total agreement that Americans deserve a stable health care market that provides access to high-quality care and affordable coverage for all,” the groups said in a statement Wednesday announcing their Affordable Coverage Coalition, which includes America’s Health Insurance Plans (AHIP), the American Hospital Association, the American Medical Association and the U.S. Chamber of Commerce. 

“Achieving universal coverage is particularly critical as we strive to contain the COVID-19 pandemic and work to address long-standing inequities in health care access and outcomes,” the coalition said.

Many of the proposals endorsed by the groups have already been included in COVID-19 relief bills released by House committees this week and House-passed legislation from last year to shore up the ACA.

The industry groups wrote in a set of “principles” that they support increasing the size of premium tax credits that help people pay for ACA coverage, and expanding that assistance to more people, including some who don’t qualify now because of income restrictions and younger enrollees who are most likely to go without insurance but whom insurers need to balance their risk pools.

ACA plans can be unaffordable for people who make too much money to qualify for subsidies, with the current cutoff at around $50,000 per year.

The groups also said they support automatically enrolling and renewing eligible people for Medicaid and premium-free marketplace plans, boosting outreach and enrollment assistance programs that were cut by the Trump administration and offering more federal funding to incentivize states to expand Medicaid to cover more low-income adults, as allowed under ObamaCare.

Twelve states have not expanded Medicaid, including Florida, Georgia and Texas. If all 12 states expanded the program — an unlikely prospect given the opposition from GOP state leaders — more than 4 million new people would become eligible for the program, according to the Kaiser Family Foundation.

Similar policies were included in a COVID-19 relief package proposed this week by the House Ways and Means and Energy and Commerce committees.

Passing health care reform through Congress is typically a challenging slog with competing and powerful special interests in the health care sector pushing back against policies that could harm their bottom lines.

But those competing interests have banded together as support grows for the public option or “Medicare for All” — policies that would mean greater government involvement in health care and potentially less money for insurers and hospitals.

Biden has pushed for a public option that would compete with private insurance plans, a proposal that is vehemently opposed by the industry.

Progressive lawmakers like Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.) have garnered more Democratic support in recent years for their Medicare for All proposals, while at the same time alienating more moderate members of the party and Republicans.

The coalition did not mention a public option or Medicare for All in its list of policies.

Some of the organizations in the new coalition, including Federation of American Hospitals and AHIP, are also part of a different coalition of insurers, hospitals and drug companies that have advocated against Medicare for All and the public option.

Still, the reforms proposed by the industry groups could go a long way toward making health insurance premiums more affordable for some people and extending coverage to the 29 million people in the U.S. who remain uninsured.

“While the country has made enormous strides in expanding coverage over the past decade, we must close the remaining gaps. Having health coverage means people can get the care they need, when they need it, so they can live healthier, more secure lives,” said Kim Keck, president and CEO of the Blue Cross Blue Shield Association, a member of the new coalition.

The groups also endorsed an “insurance affordability fund,” to be funded by the federal government, that would support “unexpected” high costs for caring for people with serious health conditions, and lower premiums or cost-sharing for enrollees in ACA plans. Such mechanisms are typically used by governments to shield insurers from some of the financial risks of insuring high-cost patients, which could lead to premium increases for everyone. A similar proposal was included in a Democratic-led bill that passed the House last year before languishing in the GOP-controlled Senate.

The coalition also backed subsidizing COBRA subsidies for laid-off workers. COBRA is a federal law that lets people continue participating in their employer-sponsored health plan for up to 18 months. The plans often become too expensive for participants because employers no longer chip in to help pay premiums.

The House Ways and Means Committee COVID-19 relief package released this week would subsidize 85 percent of COBRA premiums for laid off workers.

Some Democrats have argued subsidizing COBRA is a giveaway to health insurance companies and that there are better alternatives, like automatically renewing unemployed people and their households in Medicare plans.

“That is far less expensive than subsidies to private insurance companies,” Jayapal told reporters last month.

“I understand why people are advocates for [COBRA subsidies]. There are reasons for that. It’s quicker, obviously, but it’s far more expensive,” she said.