Stabilizing the Marketplace
Estabilizar el Mercado

By Andrea Sears | New York News Connection While the effort to repeal the Affordable Care Act was narrowly defeated, the program that has helped millions of Americans buy more affordable health insurance is still in danger. According to Craig Obey, Deputy Executive Director of the advocacy group Families USA, the Affordable Care Act is working, but confidence in the program has been undermined by threats that the Trump administration will let it implode by withholding funding for cost-sharing reductions. “Congress ought to go ahead and eliminate all uncertainty and guarantee that they’re going to make those payments, to ensure that people’s deductibles and premiums are affordable,” he says. The groups have sent a letter to leaders in Congress asking for swift, bipartisan action to ensure that cost-sharing reductions or “CSRs” are funded and to restore premium stabilization programs. “When you have the administration saying they’re going to cut 90 percent of the funds to let people know that it exists and how they can enroll, that in and of itself can be very destabilizing,” he explains. This year, the open enrollment period for the Affordable Care Act also has been cut to just six weeks, from Nov. 1 to Dec. 15 – half the length of previous years. Obey acknowledges the ACA has some problems that need to be fixed, but it also has made historic progress toward making high-quality, affordable health care available to all. He says what’s needed now is a bipartisan effort to help preserve and extend those gains. “Wherever there are improvements that are needed, we make those improvements, but let’s make the law work rather than continue to sow uncertainty with a lot of political posturing and rhetoric that just isn’t helpful,” adds Obey. For more information, please visit www.familiesusa.org. The Honorable Mitch McConnell The Honorable Paul Ryan The Honorable Chuck Schumer The Honorable Nancy Pelosi September 5, 2017 Dear Leader McConnell, Speaker Ryan, Leader Schumer, and Leader Pelosi: The undersigned organizations representing consumers, patients, and health care providers share the strong belief that everyone in this nation deserves high-quality, affordable health coverage and care. We stand committed to building on the historic progress of the Affordable Care Act (ACA) and working with you to secure meaningful and affordable health coverage for all. Continued uncertainty about funding for cost-sharing-reduction payments, evidence of administrative attempts to undermine the law, and concerns about future Congressional attempts to repeal the ACA pose a significant threat to the stability of marketplaces and the broader individual market. It is now time for Congress to move past attempts to repeal the ACA and cut the Medicaid program and turn its attention towards bi-partisan policies that would safeguard the stability of health insurance markets for 2018 and beyond. Specifically, we urge Congress to take swift action in three main areas: 1) Guarantee funding for cost-sharing reductions (CSRs). We urge Congress to immediately enact legislation that clarifies there is a permanent, mandatory appropriation that ensures full funding of CSRs, eliminating all questions raised by pending litigation. CSRs provide critical financial protection for nearly 6 million people who obtain private coverage on health insurance marketplaces.i If CSRs end, premiums would rise by an estimated 19 percent, and reduced plan participation could leave many consumers without any coverage options.ii Quick action that guarantees ongoing CSR funding is critical to ensuring a stable individual market. 2) Restore premium stabilization programs. We urge Congress to immediately appropriate ongoing funding for a premium stabilization program that shields individual insurance markets from the volatility of high-cost claims. The potential impact of such a program is illustrated by the 10 to 14 percent drop in premiums that resulted from transitional reinsurance under the Affordable Care Act.iii An ongoing, fully-funded premium stabilization program would also encourage insurers to offer marketplace coverage. 3) Ensure continued funding for outreach and enrollment assistance. We urge Congress to continue to appropriate adequate funding for federal Navigators and outreach, culturally and linguistically appropriate education, and marketing activities through the Department of Health and Human Services. This funding helps consumers—particularly young and healthy people who will help balance the risk pool—learn about and enroll into available coverage. Thank you for considering our requests. We urge you to protect the Medicaid program and preserve the coverage gains made under the ACA as you turn your attention to market stabilization efforts. We stand ready to work with you to address these urgent concerns in the short term and, in the long term, to enact policies ensuring that everyone in our nation has high-quality, affordable health coverage and care. Sincerely, Families USA iCenters for Medicare and Medicaid Services, 2017 Effectuated Enrollment Snapshot, (Washington, DC: Department of Health and Human Services, Centers for Medicare and Medicaid Services, June 6, 2017), available online at https://downloads.cms.gov/files/effectuated-enrollment-snapshot-report-06-12-17.pdf. Por Andrea Sears | New York News Connection Más de cien grupos de consumidores, pacientes y proveedores están pidiendo una acción del Congreso para estabilizar el mercado de seguros de salud. Si bien el esfuerzo para derogar la Ley del Cuidado Asequible de la Salud fue derrotado estrechamente, el programa que ha ayudado a millones de estadounidenses a comprar un seguro de salud más asequible sigue en peligro. Según Craig Obey, director ejecutivo adjunto del grupo de defensa Familias USA, la Ley del Cuidado Asequible de la Salud está funcionando, pero la confianza en el programa ha sido debilitada por las amenazas de que la administración Trump lo dejará implosionar reteniendo fondos para la reducción de costos. “El Congreso debe adelantarse y eliminar toda incertidumbre y garantizar que van a hacer esos pagos, para asegurarse de que los deducibles de las personas y las primas sean asequibles”, dice. Los grupos han enviado una carta a los líderes del Congreso pidiendo una acción rápida y bipartidista para asegurar que se financien las reducciones de los costos compartidos o “CSR” (por sus siglas en inglés) y para restaurar los programas de estabilización de primas. Obey señala que la postura política en los intentos por derogar la Ley del Cuidado Asequible de la Salud ha dejado a muchas personas pensando que el programa ya no existe, y la semana pasada, la Casa Blanca agravó el tema. “Cuando la administración dice que va a recortar el 90 por ciento de los fondos para que la gente sepa que existe y cómo pueden inscribirse, eso en sí mismo puede ser muy desestabilizador”, explica. Este año, el período abierto de inscripción para la Ley del Cuidado Asequible de la Salud fue reducido a solo seis semanas, del 1º de noviembre al 15 de diciembre, la mitad de la duración de años anteriores. Obey reconoce que la ACA tiene algunos problemas que necesitan ser arreglados, pero también ha hecho un progreso histórico hacia tener un cuidado de la salud de alta calidad y asequible al alcance de todos. Dice que lo que se necesita ahora es un esfuerzo bipartidista para ayudar a preservar y extender esas ganancias. “Dondequiera que haya mejoras que se necesiten, hacemos esas mejoras, pero hagamos que la ley funcione en lugar de seguir sembrando incertidumbre con muchas posturas políticas y retórica que simplemente no es útil”, añadió. Para obtener más información, por favor visite www.familiesusa.org.Stabilizing the Marketplace
More than a hundred health-care consumer, patient and provider groups are calling for Congressional action to stabilize the health insurance market.
Obey notes that the political posturing in the attempts to repeal the Affordable Care Act has left many people thinking the program no longer exists – and last week, the White House compounded the issue.
Majority Leader Speaker of the House
U.S. Senate U.S. House of Representatives
Washington, DC 20510 Washington, DC 20515
Democratic Leader Democratic Leader
U.S. Senate U.S. House of Representatives
Washington, DC 20510 Washington, DC 20515
Academy of Nutrition and Dietetics
ADAP Advocacy Association (aaa+)
The AIDS Institute
AIDS United
Alliance for Retired Americans
American Academy of Pediatrics
American Association on Health & Disability
American Federation of State, County and Municipal Employees
American Federation of Teachers
American Muslim Health Professionals
American Nurses Association
American Public Health Association
The Arc of the United States
Asian & Pacific Islander American Health Forum
Association of University Centers for Disabilities
Autistic Self Advocacy Network
Bazelon Center for Mental Health Law
Black Women’s Health Imperative
Cancer Support Community
Center for American Progress
Center for Law and Social Policy
Center for Medicare Advocacy, Inc.
Center for Popular Democracy
Center for Public Representation
ChangeLab Solutions
Children’s Defense Fund
Coalition on Human Needs
Community Access National Network (CANN)
Community Catalyst
Congregation of Our Lady of Charity of the Good Shepherd, US Provinces
Consortium for Citizens with Disabilities
Consumers Union
CPD Action
Disability Rights Education and Defense Fund
Doctors for America
Easterseals
Epilepsy Foundation
Family Voices
Farmworker Justice
Foundation for Healthy Generations
Friends Committee on National Legislation
The Greenlining Institute
Health Care for America Now (HCAN)
Hepatitis B Foundation
Hep B United
HIV Medicine Association
Hogg Foundation for Mental Health
International Union, United Automobile, Aerospace & Agricultural Implement Workers of America, UAW
Justice in Aging
Lakeshore Foundation
Leadership Conference on Civil and Human Rights
League of Women Voters of the United States
Medicare Rights Center
The Michael J. Fox Foundation for Parkinson’s Research
NAACP
NASTAD
National Advocacy Center of the Sisters of the Good Shepherd
National Alliance on Mental Illness
National Association for Health and Fitness
National Association of Area Agencies on Aging (n4a)
National Association of Perinatal Social Workers (NAPSW)
National Association of Social Workers
National Center for Lesbian Rights
National Center for Transgender Equality
National Consumers League
National Council of Jewish Women
National Council for Behavioral Health
National Disability Institute
National Disability Rights Network
National Family Planning & Reproductive Health Association
National Health Law Program
National Latina Institute for Reproductive Health
National LGBTQ Task Force
National Partnership for Women & Families
National Patient Advocate Foundation
National Respite Coalition
National Viral Hepatitis Roundtable
National Women’s Health Network
NETWORK Lobby for Catholic Social Justice
Organizing for America
Out2Enroll
Planned Parenthood Federation of America
Public Citizen
Raising Women’s Voices for the Health Care We Need
Religious Institute
RESULTS
Sargent Shriver National Center for Poverty Law
Service Employees International Union (SEIU)
Society for Public Health Education
TASH
Third Way
Trust for America’s Health
UnidosUS
Union for Reform Judaism
United Church of Christ, Justice & Witness Ministries
United Methodist Church – General Board of Church and Society
URGE: Unite for Reproductive & Gender Equity
YWCA
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ii 7 Larry Levitt, Cynthia Cox, and Gary Claxton, The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments, (Washington, DC: Kaiser Family Foundation, April 25, 2017), available online at http://www.kff.org/health-reform/issue-brief/the-effects-of-ending-the-affordable-care-acts-cost-sharing-reduction-payments/
iii Letter to Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer Re: The Better Care Reconciliation Act of 2017 (BCRA), from Karen Bender, Chairperson of Individual and Small Group Market Committee, and Michael Nordstrom, Chairperson of Medicaid, American Academy of Actuaries, June 30, 2017 http://actuary.org/files/publications/BCRA_Comment_Letter_063017.pdfEstabilizar el Mercado