One of BCBS's recommendations is to allow greater flexibility for high-deductible health care plans, which are currently only permitted to cover the full cost of preventative services pre-deductible. (Photo: Shutterstock)
The Blue Cross Blue Shield Association is urging Congress to boost the Affordable Care Act marketplace, both by increasing subsidies for individual health plans and putting in place a reinsurance program to protect participating health plans.
For starters, according to a report the group has prepared, Congress should revise the existing tax credits to lower premiums for those purchasing individual or family health plans through the ACA exchange. Currently, those up to 400 percent of the federal poverty level are eligible for tax credits. The report proposes that they be reconfigured so that no customer spend more than 12 percent of their income on health care.
Similarly, the report proposes increasing subsidies to help low-income customers reduce what they pay on deductibles and copays. It states that the government should cover 80 percent of total costs for those with incomes between 200-300 percent of the FPL.
“We believe everyone should have access to coverage and care, no matter who you are or where you live,” said Scott Serota, BCBS president and CEO. “The individual market is a critical source of coverage for people from all walks of life, and it should be strengthened to make coverage more affordable while protecting those with pre-existing conditions.”
Congress should also intervene to address the high costs associated with the patients with the greatest health care issues. Currently, 5 percent of the patient population accounts for almost 60 percent of health care claims. The report proposes the federal government set up a premium support program targeting those whose annual claims exceed $65,000.
The report recommends that the ACA be changed to allow greater flexibility for high-deductible health care plans, which are currently only permitted to cover the full cost of preventative services pre-deductible.
“Congress should permit HSA-qualified health plans to cover high value services before the deductible. For example, a health plan could provide coverage of insulin before the deductible to ensure patients with diabetes have access to this live-saving drug,” says the report.
In addition to improving the options for those who are enrolled, the report urges the federal government to do more to boost enrollment. Millions of people who are uninsured are unaware about the availability of affordable health plans through the ACA marketplace. The Trump administration has made steep cuts to ACA marketing.
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