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While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
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8-19-10 Affordable Care Act Update
August 23, 2010
Below is this week’s update on the Affordable Care Act. As always, thank you for all you do every day for cancer patients and their families.
“Grandfather” Rule Filing
This week, the American Cancer Society Cancer Action Network filed comments on the ‘Grandfather’ rule in the Affordable Care Act, in an effort to more clearly define which plans will be exempt from certain provisions in the new law. Overall, it is a strong rule that encourages plans to strengthen benefits for patients and ceases their ‘grandfather’ status if they choose to reduce benefits or substantially shift costs to patients. The comments filed by ACS CAN encourage the Administration to further strengthen the law for people affected by cancer by calling for greater disclosure to enrollees and more oversight of insurers. ACS CAN also responded to specific questions regarding changes to plan structure, physician network and formularies that would trigger a cessation of grandfathered status. You can view a full copy of our comments on the website.
Medical Loss Ration and the National Association of Insurance Commissioners
The NAIC completed its second meeting of the year on Tuesday. Before they adjourned, they approved the proposal for medical loss ratio (MLR) that had been recommended by an NAIC working group and was generally supported by consumer groups, including ACS CAN. The proposal now goes to HHS which must formalize it through the issuance of a federal regulation. HHS is expected to act in the next few months.
Thank you to those of you who sent emails and letters on this issue, and especially to the staff who met with their State Insurance Commissioner's office during the past few weeks. The patient and consumer perspective was a major factor in Tuesday’s recommendation, and your work was critical given that a strong lobbying effort was made by representatives of insurance brokers/agents to weaken the proposal. While just the beginning, the NAIC actions are indeed a positive first step for the patients we serve.
In addition, the NAIC indicated that they will try to develop a model act for state exchanges this fall, but the proposal is only likely to address administrative authority of state agencies to comply with the ACA and not propose any specific policy options. They will also form new subgroups to address more specific exchange issues under the Affordable Care Act, including plan certification and ratings, enrollment processes, and IT, in order to help state agencies better understand the issues and the decisions that they will have to make. We will continue to monitor these discussions and keep you apprised of documents and decisions as they are made by the commissioners.
Johanns Amendment
Last week, ACS CAN distributed a fact sheet and talking points on an amendment offered by Senator Johanns to the Small Business and Jobs Credit Act that would effectively eliminate the Prevention and Public Health Fund that was part of the Affordable Care Act. A vote on this amendment (AN 4531) is expected to be the first action taken by the Senate when they return to Washington, DC in September. The fact sheet was shared with Advocacy Leaders and Federal Directors, but because August is a busy time not only for recess activities but also for vacations, I wanted to re-distribute it to a wider audience. You will find it attached to this email.
1099_johanns_ammendment_information_sheet.doc
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)