Houston Chronicle

Health care group wants Obamacare policies expanded

- By Reed Abelson

In an unusual display of unity, groups representi­ng nearly all the major players in the U.S. health care system — hospitals, doctors, insurance companies and employers — are joining forces to urge Congress to embrace President Joe 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 Wednesday morning, including an increase in the federal subsidies available to help people afford coverage and a threeyear 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 highqualit­y care and affordable coverage for all,” the coalition said in a joint statement.

Some of the proposals, including increases in federal subsidies, already are 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 also 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 ACA, 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 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 a member of the coalition.

“This is a very specific set of proposals for the ACA framework to meet its aspiration­s,” 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 nearuniver­sal coverage.

“We worked hard with all of the partners in the coalition to put forth recommenda­tions to get us 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 jobbased plans or so the federal government can provide direct loans to employers.

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