Bolstering the individual marketplaces could lead to an additional 4 million people gaining coverage, according to the Blue Cross Blue Shield Association.
BCBSA proposed (PDF) several policy steps that could improve access and affordability in the individual market, and an analysis from Oliver Wyman suggests the platform could reduce premiums by an average of 33% on top of adding millions to the rolls.
The proposal centers on three main policies:
- Enhancing tax credits available to people purchasing plans, particularly for younger people.
- Building a sustained funding stream to support the cost of care for people with chronic illness.
- Growing outreach for enrollment.
Justine Handelman, senior vice president of BCBSA’s Office of Policy and Representation, told FierceHealthcare that these policy proposals are part of the association’s overall goals of making healthcare more accessible and affordable.
“Our No. 1 goal is to make sure everyone has access to affordable healthcare,” she said. “There’s some common sense, practical steps that could be taken now that would do that.”
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BCBSA suggests that policymakers provide greater assistance through tax breaks to people with incomes up to 400% of the federal poverty level. The plan also includes an out-of-pocket cap that would prevent enrollees from spending more than 12% of their incomes on their insurance premiums.
Though the proposal aims to expand options for younger people, Handelman said that older people wouldn’t lose any of the assistance they currently enjoy.
“It really makes it fair for younger people who today aren’t really getting a good value for what they pay for coverage,” Handelman said.
The proposal comes as the Trump administration has signaled its openness to changes that could restore cost-sharing reduction payments, which were suspended by the Department of Health and Human Services in 2017.
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Handelman said that restoring some kind of cost-sharing subsidy is crucial to bringing down costs on the Affordable Care Act exchanges, but they can’t simply be put back in place like nothing has changed over the past two years.
Many insurers responded to the end of CSRs by silver-loading, a practice where they would put most premium increases on silver plans. As these plans are used to set federal subsidies, the amount of subsidies went up.
However, reinstituting CSRs in tandem with other policies to strengthen the markets would be a significant improvement, she said. And BCBSA believes there’s bipartisan support to make this happen.
“The sense we’re getting is there is bipartisan interest and agreement that we need to do these three things,” Handelman said.