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AMA advocates to protect, improve affordability of health insurance

David O. Barbe

During its annual meeting, AMA took action to protect and sustain ACA marketplaces and enhance affordability in the health insurance exchanges.

ACA marketplaces

Health insurance plans being sold in the individual and small group markets must guarantee important patient protections under the ACA. These protections include pre-existing coverage of vital health benefits, as well as safeguards against annual and lifetime limits and out-of-pocket expenses, according to AMA.

“The AMA knows that insurers are more likely to participate in marketplaces with large and healthy risk pools,” David O. Barbe, MD, president of AMA said in a press release. “We need to take steps to ensure that healthy individuals stay enrolled in coverage offered in the ACA marketplaces and are not siphoned off into coverage that does not guarantee critical patient protections, leaving behind a sicker population facing higher premiums in ACA-compliant coverage.

“At some point, people who are currently healthy are going to have to seek medical care, and we need to make sure that they avoid sham coverage that does not provide them with the coverage and financial protection they counted on at the time of enrollment,” he added.

Due to concerns that insurers will leave some ACA marketplaces, AMA argued that a back-up plan is needed to ensure that patients have coverage options at all times. AMA advocated for the two largest Federal Employees Health Benefits Program insurers in counties without a marketplace plan to provide at least one silver-level marketplace plan.

Health insurance exchanges

The AMA announced support for a policy that would allow more individuals to afford and obtain health insurance coverage by offering premium subsidies to individuals and families with incomes up to 500% of the federal poverty line.

AMA also supported providing additional premium tax credits for premium subsidy-eligible young adults aged 19 to 35 years to incentivize them to enroll in exchange coverage.

“We must build on the gains of the Affordable Care Act and make coverage more affordable for Americans by extending the eligibility for premium tax credits and increasing tax credit amounts for young adults that will result in greater coverage,” Barbe said in a press release.

Additionally, AMA urged for state-level individual mandates, auto-enrollment and a permanent federal reinsurance program. – by Alaina Tedesco

Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.