Pension & Benefits News Congress needs to do more to ensure affordable health coverage during pandemic, large employer groups say
Wednesday, June 3, 2020

Congress needs to do more to ensure affordable health coverage during pandemic, large employer groups say

By Pension and Benefits Editorial Staff

In a letter to congressional leaders, several large employer groups have offered recommendations to ensure access to high quality, affordable health care during the COVID-19 pandemic. While employers will continue to have a “central role to play in continuing to ensure America’s families” have access to health care, the groups note that nearly 30 million individuals have become unemployed since March, and Congress needs to do more to “ensure our employees, their families, and everyone in our country” has access to health insurance during and after the pandemic.

Led by the American Benefits Council, the ERISA Industry Committee, the National Alliance of Healthcare Purchaser Coalitions, and the Pacific Business Group on Health, the letter was signed by more than 30 organizations.

“The pandemic has placed unprecedented strain on our country’s health care payment and delivery systems,” the organizations wrote. “As Congress and the administration grapple with this rapidly evolving and highly destructive crisis, we urge policymakers to contemplate immediate and longer-term coverage policies as separate and distinct.”

Recommendations. The main recommendations included in the letter are: (1) providing affordable coverage in the immediate and longer term; (2) ensuring access to primary care clinicians; (3) stopping price gouging and protecting patients from surprise billing; and (4) mitigating of risk in the insurance market.

Among the ideas for reform, the organizations would like Congress to:

  • Ensure sufficient COBRA subsidies to protect patients. Any solution to ensure access to employer-sponsored coverage through COBRA also must include federal subsidies covering 90 percent to 100 percent of the cost for those who have lost their jobs or have been furloughed.
  • Increase access to telehealth coverage. Telehealth should be able to be offered as a standalone benefit to workers not enrolled in the company’s medical plan, and state barriers to telehealth care should be eliminated.
  • Curb health care cost increases. Congress should take meaningful steps to curtail high and rising health care costs, by eliminating unnecessary spending, poor resource allocation, and unsustainable high prices.
  • Guarantee access to primary care. The groups note that around the country, primary care providers are reporting dire financial situations due to the loss of patient revenue during the pandemic. “As these smaller practices struggle and threaten to close because of this pandemic, we fear this could exacerbate already problematic provider consolidation—giving even more market domination to physician staffing firms and other parties already positioned to command exorbitant prices,” the organizations said.
  • Protect patients from price gouging and surprise bills. The groups believe that Congress should mandate that any required COVID-19-related services that must be provided without patient cost sharing should be paid at the Medicare fee schedule when provided out-of-network. In addition, policymakers should enforce a price-gouging ban, and require health care price transparency.


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