lobbying_activities: 1985028
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| 1985028 | 5e231365-9255-4d8c-aafb-be5807644fd2 | Q2 | MARSHFIELD CLINIC HEALTH SYSTEM | 57830 | MARSHFIELD CLINIC HEALTH SYSTEM | 2017 | second_quarter | INS | HR 1628, the American Health Care Act (AHCA) will result in a large number of individuals covered under the Affordable Care Act (ACA) with preexisting conditions to lose the necessary coverage to maintain their health. MCHS recommended opposition to the AHCA and any changes to the coverage afforded by the ACA. The changes proposed under the AHCA will undermine what works in the ACA without improving on the circumstances, coverage and care of Wisconsin residents in the individual and small group market. We urged Congress to take steps to improve and repair health coverage in the areas where the ACA was falling short, and to also maintain the gains that the ACA has provided to assure that no one, especially those near poverty, fall through the cracks: Near term stability of the individual market: In the short term, it is imperative the individual market remain a stable, viable option for people to get and maintain coverage. Through Security Health Plan, Marshfield Clinic Health System has seen many people who previously did not have coverage secure coverage, sometimes for the first time. Ensuring that this market is stable through 2018 will give enrollees and health insurers time to enact new reforms aimed at making care more affordable in the long term. Maintaining coverage for the near poverty population: Replacement plans should consider the low income population under 250 percent of the Federal Poverty Line. Half of Security Health Plans membership purchasing a plan on the individual market falls into this category. The AHCAs elimination of cost sharing subsides would have a significant impact on the affordability of care and will increase bad debt to providers which ultimately increases costs for everyone. Stability and continuity of coverage for this population is critical to the health of rural Wisconsin. Reduction in uncollected medical debt: Hand in hand with coverage of the near poverty population is the reduction in uncollected medical debt care providers have experienced. This reduction has allowed integrated delivery systems, like Marshfield Clinic Health System, to keep overall commercial rates down. If uncollected medical debt were to again increase due to an increase in the uninsured rate, the commercial market pricing (i.e. employer group market) will bear the brunt of price increases. Flexibility in coverage of care that saves long term costs: Marshfield Clinic Health System has been a leader in providing care in alternative settings that saves cost, maintains quality and improves patient experience. Programs such as our comfort and recovery suites save our patients considerably more than the cost of the same procedure done in an inpatient setting. Marshfield Clinic Health System would advocate for the opportunity to use these programs for any patient, but due to regulatory barriers cannot (e.g. Medicaid beneficiaries). Flexibility in benefits offered: Today, due to Federal regulation, health insurers are mandated to cover a set of essential health benefits with little flexibility in altering coverage. This approach leaves minimal opportunity to design benefit plans that meet the needs of particular populations (i.e. the very young or near Medicare populations). A more flexible, state-based approach to regulating the benefits that can be offered in health insurance product is preferable. Regionalized high risk pools: Wisconsin has significant experience with high risk pools, like the Health Insurance Risk Sharing Pool. If risk pools are enacted in a thoughtful manner, they can reduce the cost to consumers across the commercially insured population. Marshfield Clinic Health System would advocate for the establishment of high risk pools managed by the private market and infused with federal dollars. Integrated care delivery systems are uniquely positioned to manage the risk of these high care need populations. HR 1628 the Better Care Reconciliation Act -- MCHS expressed reservations about the Better Care Reconciliation Act (BCRA) as currently written. Challenges of serving rural Wisconsin . We serve about 1 million residents in our rural area Subsidization of health coverage for low income Wisconsinites has helped mainstream tens of thousands into traditional commercial coverage through the Health Insurance Marketplace. This has been vital to the health of our patients enabling us to educate patients and include them in prevention programs. Impact of the Better Care Reconciliation Act -Tax credits are income based, but only up to 350% of the FPL versus 400% as in the ACA. The impact of this is significant to the population we serve. -Cost sharing subsides are eliminated as of 2020. This will mean increases in out-of-pocket expenses for those under 250% of FPL of thousands of dollars. -The benchmark plan will be lowered to 58% actuarial value (currently at 70%). That reduction will substantially lower the amount of tax credit people will be eligible for and will likely make most plans unaffordable for those under 250% FPL. While the House of Representatives did acknowledge the divide between expansion and non-expansion states, the House-passed bill came up far short of providing true equity and fairness in the system. The Senate BCRA has not improved on the equity of the formula, and in the most basic analysis, taxes paid in Wisconsin will go to fund expansion in other States. We urge you to demand fairness for Medicaid payments throughout the States, including Wisconsin. | Centers For Medicare and Medicaid Services (CMS),Health & Human Services, Dept of (HHS),HOUSE OF REPRESENTATIVES,SENATE,Veterans Affairs, Dept of (VA) | 90000 | 0 | 0 | 2017-07-11T13:31:19.420000-04:00 |