Hospitals, doctors, insurers and employers say the Affordable Care Act can help the country achieve universal coverage
In an unusual display of unity, groups representing nearly all the major players in the American health care system — hospitals, doctors, insurance companies and employers — are joining forces to urge Congress to embrace President Biden’s broad vision of building on the Affordable Care Act to reach the long elusive goal of universal coverage.
The coalition is composed of eight powerful industry groups, including America’s Health Insurance Plans, the American Medical Association and the U.S. Chamber of Commerce. It released a detailed set of proposals on Wednesday morning, including an increase in the federal subsidies available to help people afford coverage and a three-year re-establishment of the generous match in federal funding to states to entice more of them to expand their Medicaid programs. The coalition also urged the government to spend more money on enrolling people in plans offered by the insurance markets established under the law, efforts that were slashed by the previous administration.
“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 coalition said in a joint statement.
Some of the proposals, including increases in federal subsidies, are already being discussed as part of a broad Covid-19 relief bill and have long been on a list of proposals made by the groups to Congress.
The decision to work together was fueled by the pandemic, the coalition said, and by the need to address “longstanding inequities in health care access and disparities in health outcomes.” Millions of Americans lost their insurance during the downturn, and the virus has disproportionately affected communities of color, which have experienced high numbers of cases and deaths.
The recommendations signal a strong show of support for the beleaguered health care law, which had been under fierce attack not only from Republicans under the Trump administration but from progressive Democrats who have urged replacing it altogether with a government-run “Medicare for all” system.
While the hospitals, the doctors and the insurers, which benefit when more people have coverage, had previously united to fight the attempts to repeal Obamacare by the Republicans in 2017, the new coalition also includes the Chamber, which had not been a proponent of the law.
“We have always believed that there are better approaches to expanding health care coverage and lowering costs than the A.C.A., but it is the law of the land and as such we want it to function as smoothly and efficiently as possible,” Neil Bradley, the executive vice president and chief policy officer for the Chamber, said in an emailed statement.
Given the election of Mr. Biden and the change in the composition of Congress, “we now have an opportunity to see something actually happen,” said Chip Kahn, the president of the Federation of American Hospitals, which represents for-profit hospitals and, along with the American Hospital Association, is a member of the coalition. In addition to the American Medical Association, the American Academy of Family Physicians is also a member of the coalition.
“This is a very specific set of proposals for the A.C.A. framework to meet its aspirations,” Mr. Kahn said.
The coalition now estimates that 29 million working-age people remain uninsured, and it says that the proposed measures are a way to achieve near-universal coverage.
“We worked hard with all of the partners in the coalition to put forth recommendations to get us to where we need to a pathway to really expand coverage,” said Justine Handelman, a senior vice president for the Blue Cross Blue Shield Association, which is a member of the coalition.
Employer groups, which include the American Benefits Council, are particularly supportive of temporary measures that would help people retain their job-based coverage during the pandemic. The coalition is calling for higher subsidies under COBRA, the federal law that allows people to retain employer-provided health benefits after leaving a job, so that people can afford to keep those job-based plans or so the federal government can provide direct loans to employers.
“It’s really all about the existing system and figuring out the gaps and issues,” said Jeanette Thornton, a senior vice president at America’s Health Insurance Plans. All of the recommendations are “about filling those gaps,” she said.
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