2021 Hero BCBSA AHIP Recommendations Health Care Cost

Policymakers can expand access to care, ensure affordability and advance health equity. Here’s how.

As the nation begins to recover from the COVID-19 pandemic and its twin economic and public health crises, policymakers are quickly considering legislation to invest in America’s future — including proposals to help families and children thrive, bolster the workforce and rebuild our infrastructure.

Over the past year, we’ve seen how important it is that every American has equal access to high-quality, affordable health care coverage as long-standing racial health disparities were compounded to tragic proportions, with communities of color disproportionately affected by COVID-19.

In a joint letter to Congress, BCBSA and America’s Health Insurance Plans (AHIP) outlined recommendations to build a better future for every American. The following steps can expand access to care, ensure affordable coverage and advance health equity.

Ensure health care affordability for hardworking Americans

Policymakers should make permanent the enhanced premium tax credits in the American Rescue Plan Act (ARPA) and adjust them for younger consumers to encourage them to purchase coverage. Policymakers should also lower cost-sharing requirements for enrollees in the individual market.

Support patient access to affordable prescription drugs

Congress should enact Medicare Part D structural reform, primarily by creating a maximum out-of-pocket cap and simplifying the benefit design. Policymakers should also repeal the Health and Human Services (HHS) Office of the Inspector General’s Rebate Safe Harbor Final Rule, which would increase Medicare beneficiaries’ Part D premiums by up to 25 percent and government spending by nearly $200 billion over the next 10 years. Congress is also urged to advance pro-competition, market-based reforms, such as ending anti-competitive pay-for-delay arrangements and patent abuses.

Advance health equity

To accelerate efforts to reduce racial health disparities, Congress should support sociodemographic data standardization and interoperability while maintaining appropriate safeguards and privacy protections. Lawmakers should also ensure that any final health package extends the 12-month post-partum coverage included in the ARPA from a five-year option to a permanent option for states to use in combating maternal mortality, and provide coverage and reimbursement of evidence-based doula services for pregnant beneficiaries.

Ensure strong public-private partnerships in government programs

We recommend Congress build on the success of the Medicare Advantage (MA) and Part D programs by avoiding harmful cuts that could increase premiums or reduce benefits to enrollees. Lawmakers should pass the Ensuring Parity in MA and PACE for Audio-Only Telehealth Act — legislation that will assure that telehealth services delivered during this extraordinary time are appropriated accounted for.

Additionally, Congress can ensure that Medicaid enrollees continue to have reliable access to quality care by extending incentives for Medicaid expansion; continuing enhanced Federal Medical Assistance Percentage (FMAP) for states during the Public Health Emergency (PHE) and Maintenance of Effort (MOE) requirements for states accessing additional FMAP funds and provide a glide path after the PHE in order to avoid significant disruptions for states, enrollees and providers.

See the full recommendations in a joint AHIP-BCBSA letter to policymakers.


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