Af­ford­abil­ity is key

At­ten­tion must be paid to law’s pro­vi­sions that threaten to in­crease costs

Modern Healthcare - - OPINIONS COMMENTARY -

With the le­gal ques­tions re­gard­ing health­care re­form set­tled, job No. 1 must be tack­ling the very se­ri­ous af­ford­abil­ity is­sues ahead. Af­ford­abil­ity is the is­sue that keeps mil­lions of Amer­i­cans awake at night. It is the is­sue that ag­o­nizes small-busi­ness own­ers strug­gling to keep their doors open. It is also a strate­gic chal­lenge to large Amer­i­can em­ploy­ers fac­ing global com­peti­tors from na­tions that de­vote a much lower share of their spend­ing to health­care. Af­ford­abil­ity is what will ul­ti­mately de­ter­mine whether or not health­care re­form works.

The facts are well known in pol­icy cir­cles. We spend more, far more, than our OECD com­peti­tors, and health­care crowds out in­vest­ments in other crit­i­cal na­tional pri­or­i­ties such as ed­u­ca­tion and in­fra­struc­ture. Ris­ing health­care costs are a con­trib­u­tor to stag­nant wage growth.

What can be done? First and fore­most, we need to fo­cus on pro­vi­sions of the law that raise costs. That starts with re­peal­ing the mis­guided pre­mium tax that the Con­gres­sional Bud­get Of­fice has said will result in dol­lar-for-dol­lar pre­mium in­creases for in­di­vid­ual mar­ket pur­chasers, small em­ploy­ers and those cov­ered by pri­vate Medi­care and Med­i­caid plans. Tax­ing health­care cov­er­age can only make that cov­er­age more ex­pen­sive, not more af­ford­able.

The es­sen­tial health ben­e­fits and ac­tu­ar­ial value pro­vi­sions are in­tended to en­sure that all Amer­i­cans have qual­ity cov­er­age. But in com­pelling mil­lions of cur­rently in­sured Amer­i­cans to pur­chase much more cov­er­age than they cur­rently have, they will, by def­i­ni­tion, result in higher costs. Th­ese pro­vi­sions need to be im­ple­mented with af­ford­abil­ity squarely in mind and need to be con­stantly mon­i­tored to as­sess whether more flex­i­ble ap­proaches would pro­vide re­lief to in­di­vid­u­als and small em­ploy­ers.

A sys­tem-wide, all-stake­holder com­mit­ment to de­liv­ery and pay­ment re­form also is needed. Health plans and providers are part­ner­ing more ac­tively than ever to pro­mote preven­tion and well­ness, help pa­tients and physi­cians man­age chronic dis­ease, and re­ward qual­ity care. The law in­cludes promis­ing pi­lots aimed at get­ting pub­lic pro­grams to em­u­late pri­vate-mar­ket in­no­va­tions. Both sec­tors need to con­tinue build­ing upon the progress be­ing made to im­prove qual­ity, en­sure greater value for our na­tion’s health spend­ing and pro­mote af­ford­abil­ity.

Karen Ig­nagni is pres­i­dent and CEO of Amer­ica’s Health

In­surance Plans

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