By Scott Keefer - Vice President of Public Affairs

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Future of Health Reform: What’s needed next

July 19, 2017

While Congress debates exactly how to write the next chapter of health reform, the ongoing uncertainty continues to be a major source of stress and anxiety for the people of Minnesota.

Clarity is sorely needed, for many reasons.  I’d like to share Blue Cross’s perspective on what we believe needs to come next.

Our first priority– make sure reform works for Minnesotans

Blue Cross is working hard to ensure that everyone has access to a range of high-quality, affordable coverage options.

Going forward, major changes are necessary to reshape health care. We recommend a careful approach to bring more price and enrollment stability to the market while reducing the potential for any unintended consequences that no one wants to see happen— such as an increase in the number of people choosing to go without coverage.

Blue Cross has identified four key areas that need more attention and discussion:

  1. Short-term stability. It’s no secret that the individual market is facing many challenges. In the short term, priority should be given to those measures that can stabilize a very volatile market. For example, there need to be strong incentives in place for keeping healthy people in the market year-round – known today as an “individual mandate.” If not, people will understandably wait to purchase coverage until they need it – which drives up costs for everyone. If the individual mandate goes away, strong alternatives can be found in the ways that Medicare and employer-based plans encourage enrollment. In those markets, the incentives are clear for voluntarily signing up for full-year coverage at specific times. The same incentives have potential for the individual market, improving the balance between healthy and less health individuals.
  2. Medicaid funding. Adequate ongoing federal funding is necessary to maintain Medicaid as a viable program. Minnesota has made significant gains over the last two decades in providing access to care for those in need by offering coverage in state health plans. These programs are helping reduce the uninsured rate and improve health care outcomes in our state.Those gains are put at risk with the changes to Medicaid being proposed in Congress. This would be particularly challenging during the next inevitable economic downturn, when more individuals and families rely upon Medicaid as a necessary safety net program.
  3. Affordability. Ongoing financial help for low and moderate-income individuals and families is extremely important to keep people covered.Cost sharing reduction (CSR) subsidies help moderate-income families by reducing the burden of copays and deductibles. These should be maintained. Similarly, advanced premium tax credits, which reduce the premiums low and moderate-income families pay, are essential. Those tax credits should also be adjusted by age to encourage younger individuals and families to participate in the individual market.
  4. Transition. The legislation should provide an adequate transition period to the entire health care system enough time to implement any changes. Just like the Affordable Care Act wasn’t turned on with the flip of a switch, it will take at least two years to implement additional changes to the system.
Blue Cross is committed to work for improvements

We recognize the stakes are high for everyone. This is especially true for those who have coverage through Minnesota’s individual market or the Medicaid program.

We want to ensure that health care is available and affordable, and that all markets are stable and financially sound. With this focus as our guide, Blue Cross is committed to work with elected officials and all stakeholders to help reshape health care.

About Scott Keefer
As vice president of public affairs, Scott Keefer represents Blue Cross as Minnesota’s health care leader with key stakeholder groups, including members, employees, community and civic groups, regulators and as a media spokesperson. He also leads the coordination of all state and federal advocacy and policy initiatives.

About the Future of Health Reform Series
The Future of Health Reform is an ongoing series focused on the many changes taking place throughout the health insurance industry. Through this series,  Blue Cross looks at various policy issues that are rapidly shaping the transformation of health care across Minnesota and the nation. Keefer shared perspective on the future of the individual market in this blog post.


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