Advocates warn of ‘significant time bomb’ with healthcare barriers

The Rhode Island Parent Information Network is going on 35 years helping residents “turn challenging situations into opportunities,” as the healthcare nonprofit describes it.

RIPIN saw how badly Rhode Islanders struggled when Medicaid “unwinding” took place during 2023 and 2024. The impending loss of Affordable Care Act subsidies is going to repeat that scenario, said Shamus Durac, staff attorney with RIPIN.

Durac was one of several consumer advocates who urged regulators Monday to focus efforts on health care coverage access during the National Association of Insurance Commissioners’ fall meeting.

“The first thing that we saw when the unwinding happened was consumers experiencing shock and confusion about why things were changing," Durac said. "That's already happening now. People are making their coverage decisions for next year, and if they hadn't yet been tuned in, they are now, after they see what their premiums are looking like."

Federal tax credits that have helped make their health insurance affordable are set to end Jan. 1, unless Congress acts. The U.S. Senate could vote on extending those enhanced tax credits Thursday, but the plan may not have the bipartisan support needed to advance.

As a result, many Americans could see their health care premiums double or even triple.

NAIC/Consumer Liaison Committee meeting Monday featured several presentations by advocates on the devastating impacts to come if the subsidies are not extended.

It’s estimated that more than 14 million Americans will lose health insurance over the next decade, said Jennifer Snow, national director of government relations and policy at the National Alliance on Mental Illness.

“This dramatic shift is going to have detrimental effects on families at all income levels and all states,” Snow noted. “So, we have a significant time bomb coming down the pike.”

'Forced to have to pay more'

Beyond the political issues with the ACA, there are persistent financial barriers to everyday Americans getting access to quality health care, Snow said.

“Whether it's utilization management, like prior authorization, where people have to jump through hoops to get the care prescribed by their doctors, or limited provider networks where people cannot find a provider in their network, they're forced to have to pay more to get they need or go without,” she said.

Snow displayed several stories from anonymous Americans paying healthcare bills as high as their mortgage payment. “Donna from Virginia” cashed in her family’s life insurance policy to pay for medications that cost more than $1,000 a month.

Silvia Yee is the public policy director at Disability Rights Education and Defense Fund. She discussed the widespread impact on communities when vaccinations are harder to get.

“When we have individuals that we go to school with, that we work with, when they can't get the vaccines or tests for a worrying symptom, the entire community they serve is hurt,” Yee said.

Vaccinated populations can lower health care costs, prevent the complications with required hospitalizations and help hospitals preserve valuable resources at a time when those resources are dwindling, Yee said.

States can do more to preserve access to scientifically valid vaccinations, she noted.

Kennedy impact on healthcare

Department of Health and Human Services Secretary Robert F. Kennedy Jr. has targeted vaccine research and unilaterally rolled back vaccine recommendations, among other actions. Kennedy went after the Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP), which makes recommendations for the public’s use of vaccines, firing experts and replacing them with vaccine skeptics.

According to recent reports, at least 26 states have taken new actions to preserve or expand vaccine access in response to changing federal vaccine policy.

These efforts include allowing pharmacists or other non-doctor providers to administer vaccines without a prescription, and authorizing state‐level public health guidance or advisory panels to supersede or supplement federal recommendations.

In closing, Yee acknowledged the rising costs of healthcare and the efforts to keep costs down. But those efforts can be self-defeating, she added.

“Lowering health care claims by restricting access to needed health care is not a true response to controlling healthcare, healthcare costs or healthcare demand,” she said. “It only puts off necessary and preventive care, and therefore increases healthcare costs in future, even if there is some element of short-term gain.”

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InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.