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Sunday, November 19, 2017
HomePolicyAffordable Care ActA Refreshing Start on What Truly Made America Great

A Refreshing Start on What Truly Made America Great

The challenges are great.  Eighteen million Americans, 6% of all Americans, are enrolled in marketplace plans. The impact of market instability is real and painful to Americans across the country.  Proposed premium rates for 2018 in Tennessee include 21-42% increases because of uncertainty regarding ongoing reimbursement to insurance companies to offset the discounts provided to the lowest income individuals for out-of-pocket costs, including copayments and deductibles.  These reimbursements paid by the federal government, called Cost-Sharing Reductions (CSRs) are not bail-outs as they have been characterized by President Trump.  These are justifiable reimbursements to insurance companies for discounts for the poorest marketplace enrollees.  If federal CSR payments are stopped, the insurance companies will recoup the cost by increasing premiums for other enrollees.  This is not sustainable.

Another sign of distress is the decline in the number of marketplace plan per counties across the U.S.  Senator Alexander reported that initially only 4% of counties had just one insurer.  This number is now 50%.  Time is another major challenge.  The HELP committee must forge and pass a legislative solution and this policy solution must be approved by Congress by September 27, 2017, to stabilize the individual markets for 2018 as annual enrollment begins.  Americans can do extraordinary things when they have the will and work together.

You can watch live HELP committee hearings via https://www.help.senate.gov/hearings.  Hearings will be held September 7 at 9 am EDT and September 12 and 14 at 10 am EDT.


Photo credit: Library of Congress

Written by

cmyers9@utk.edu

<p>Carole R. Myers, PhD, RN, is an associate professor in the University of Tennessee-Knoxville College of Nursing with a joint appointment in the university’s Department of Public Health. She coordinates interdisciplinary graduate health policy courses and a graduate certificate in health policy. Dr.Myers’ research centers on policymaking and health services with an emphasis on access to care, TennCare, public health programs and advanced practice registered nurses. She was a 2012 American Advocacy Institute Fellow and is a strong advocate for access to high-quality, cost-effective care. Dr. Myers has received the TN-PAC Advocacy Award, the Nurse Practitioner Advocate State Award for Excellence from the American Association of Nurse Practitioners and the Tennessee Nurses Association Louise Browning Political Nurse Award. She frequently writes and speaks to professional and community groups about the Affordable Care Act and other aspects of national health care reform. Dr. Myers served as co-chair of the Tennessee Scope of Practice legislative task force and has recently been leading discussions on the transformation of health care and the role of APRNs and grassroots advocacy. She brings her health policy expertise to the airwaves twice a month on NPR’s Morning News at 91.9 FM WUOT in Knoxville.</p>

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