Even as Anthem, one of the nation’s largest insurers, reported an improved financial picture for the last year, the company warned on Wednesday that it would consider leaving some federal health care marketplaces or raising its rates sharply if the government does not continue subsidies to help low-income people.
Joseph R. Swedish, the company’s chief executive, set a deadline of early June for a decision on the subsidies, saying Anthem would weigh increasing rates by at least 20 percent next year.
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The conventional approach to health insurance keeps consumers in the dark about how their health care dollars are spent. Patients pay premiums every month and rely on insurers to cover their medical expenses, no matter how small or routine. Consequently, patients have little incentive to be cost-conscious. The more care they consume, the more value they capture for their premium dollar. Health Savings Accounts inject much-needed competitive forces into the health care marketplace. Expanding access to HSAs should be a centerpiece of any congressional effort to expand access to quality, affordable health care.
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The “MacArthur Amendment” to the American Health Care Act is responsive to what House Republicans have learned about the priorities different factions within their coalition. The Freedom Caucus prioritizes deregulation of the individual insurance market to lower costs and constrain the federal role. The moderates prioritize coverage levels and protection for people with pre-existing conditions. Rather than try to arrive at a single overall balance, the approach Republicans are now pursuing allows state governments to have relief from the rules that drive up costs and make their insurance markets unsustainable if they propose alternative rules that would still protect people with pre-existing conditions and make coverage accessible.
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The Invisible Risk-Sharing Program (IRSP) will stabilize the individual insurance market and lower premiums while concurrently providing guaranteed access to coverage and protecting those with pre-existing conditions. Different than a traditional high-risk pool, no one is declined coverage, enrollees with pre-existing health conditions get the same plans at the same lower price as a healthy individual, and those with pre-existing conditions are not segregated to higher cost and limited benefit high-risk pool plans. Several questions have been raised about IRSP and the amendment. We address a number below.
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Health information technology regulations have become overly burdensome, according to Health and Human Services Secretary Tom Price, who vowed that the Trump administration would work to spur innovation in the field. This week, he laid out several principles he said would guide the Trump administration on health IT and electronic medical records, saying the administration was committed to promoting the exchange of medical information between providers. “We simply have to do a better job of reducing the burden of health IT on physicians and other providers,” said Price.
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