America’s Front-line Physicians Tell Senate It is Imperative to Stabilize Health Insurance Markets

WASHINGTON, Sept. 14 -- The American College of Physicians issued the following news release:

Patients need to have access to a wide variety of affordable and comprehensive health insurance coverage options, said a coalition of major physician groups today in testimony submitted to the Senate Health, Education, Labor and Pensions Committee. The groups, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association, represent more than 560,000 physicians who care for patients in rural, urban, wealthy and low-income communities, and are the foundation of the American health care system.

The groups applauded the committee's efforts to develop bipartisan solutions to strengthen and improve the health insurance market and laid out a set of recommendations for the committee.

They said that Congress should make a long-term commitment to funding cost-sharing reduction payments in order to help ensure coverage is affordable and accessible for vulnerable patients.

"Unless CSRs are funded, a tremendous number of Americans will simply go without coverage and move to the ranks of the uninsured," said Michael Munger, MD, president of the American Academy of Family Physicians. "This threatens not just their own health and financial stability, but also the economic stability of their communities. Congress must take action now to fund CSR payments. At this point, only Congressional action can help consumers."

The groups told Congress that reinsurance and other risk-stabilization programs must be continued to offset the cost of insuring high-risk individuals and curbing excessive premiums.

"During such uncertain times in healthcare policy, children and families need certainty when it comes to accessing affordable health care coverage that meets their needs. Improvements such as comprehensive reinsurance programs will allow the private marketplace to offer affordable options for families, just like Medicaid and the Children's Health Insurance Program already do," said Fernando Stein, MD, FAAP, President, American Academy of Pediatrics.

Millions of Americans remain unaware of the types of assistance available to help them afford and enroll in health insurance. The groups told Congress that education and outreach efforts must be funded to tell consumers about the assistance available to them.

"Our Nation's goal should be to ensure coverage for as many individuals and families as possible. Many Americans need help in enrolling, in understanding open enrollment and in choosing the best policy for themselves and their families. These individuals are not helped, and our goal is harder to reach, when the Administration shortens the 2018 open enrollment period and cuts funding for consumer advertisements and enrollment assistance," said Haywood L. Brown, M.D., president of the American Congress of Obstetricians and Gynecologists. "We believe that more educational efforts and intensive outreach are needed, especially after so many months of program uncertainty and instability. This will ensure a better risk pool and prevent low enrollment, higher premiums and market destabilization."

They told Congress that any efforts to stabilize the markets and reduce costs must not jeopardize the coverage patients have today. The protections for essential health benefits covered today, including maternity and mental health coverage and substance use disorder treatments, must be continued.

"Continuing these essential benefits is especially vital," said APA CEO and Medical Director Saul Levin, M.D., M.P.A. "We cannot reverse our gains under current law that ensure that there is adequate access and coverage for mental health and substance use treatment and other essential health benefits, such as maternity care. This is critical when you consider the opioid abuse epidemic that is gripping the country," Levin said. "The economic and human costs of this epidemic are already too great to bear, and without treatment that is affordable and accessible, they will surely rise."

The groups asked Congress to both enforce current requirements that all individuals purchase health insurance and to explore other incentives for young, healthy individuals to buy health coverage.

"Participation among all demographic groups, particularly the young and healthy, is necessary not only for the economic balance of the ACA to function, but also essential for access to care. As physicians, we know all too well that health needs are not always predictable, and no one is immune to injury or illness. Management of potential catastrophic medical expenses, as well as preventive care is essential for a healthier America," said Mark A. Baker, DO, American Osteopathic Association President.

Lastly, the groups asked Congress to establish a public insurance option in all health insurance marketplaces in order to broaden consumer choice and invigorate market competition.

"Currently exchanges in some states are having difficulty attracting enough insurers and some patients may only have one insurer from which to obtain coverage. A public option would provide more options and increase competition," said Jack Ende, MD, MACP, president of the American College of Physicians. "One potential approach could be to offer a buy-in program for Medicare or another public health program. This type of program could expand access to clinicians and continuity of care for individuals changing over to Medicare, while at the same time it could help to reduce premiums and for individuals in the health insurance marketplaces."

In closing the groups offered to work with the committee on the development of any reforms where their collective experience and expertise could be of value.