Effort to Stabilize Market Means Little if Coverage, Affordability Disrupted

Statement by John Rother, President and CEO of the National Coalition on Health Care

“We are pleased that the Department of Health and Human Services is considering regulatory and administrative steps to assure stability and affordability in the non-group and small group markets.  In the weeks ahead, with its member organizations, NCHC will evaluate how the specific provisions of this regulation impact affordability and stability.

“But no market stabilization effort can succeed if policymakers disrupt existing coverage arrangements rather than improving on them.

“To provide any real assurance of stability as the current health care debate proceeds, leaders in Congress and the Administration will have to make a few broader policy commitments—both for the 2017-2018 period and future years:

  • Maintain Tax Credits and Cost-Sharing Assistance: To avoid destabilization of the non-group market, financial assistance for low- and moderate-income consumers, now provided through the Affordability Tax Credit and Cost Sharing Reduction subsidies, must either be maintained or improved upon.
  • Preserve the State Option to Expand Medicaid Eligibility:  Medicaid policy impacts the individual and small group markets in all fifty states. The Department of Health and Human Services estimates that Marketplace premiums are 7% lower for those states which have expanded Medicaid. Even if Congress retains tax credits and cost-sharing assistance, any substantial rollback of federal matching support for Medicaid expansion, or Medicaid in general, would push more lower-income consumers into their states’ already unsteady non-group markets.  This could drive up premiums and generate further instability in the private market.
  • Provide Ongoing Risk-Stabilization Support: Full federal payments must be made under the existing reinsurance program, a mechanism designed to partially offset the claims of high-cost patients. Moving forward, additional, federally-funded risk stabilization support is needed to offset the high-cost claims for those consumers with significant medical needs.  This support is crucial to ensure market stability and to mitigate cost growth.

“We call on leaders in Congress and the Administration to quickly commit to these goals, and turn promptly to the difficult, bipartisan work of improving health care affordability.”

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The National Coalition on Health Care (NCHC), the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients, women, minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 100 million Americans.

Some members of NCHC do not, or cannot, take positions either on specific legislation, strategies or on any policies outside their respective mission areas. However, all that can, do endorse broad policy positions in support of comprehensive health system change.