A Look at the Federal Landscape: Updates on Access and Cost

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Topics include: Financial and Insurance

How do healthcare access and cost affect cancer patient care? Healthcare attorney John Wylam, from Aimed Alliance, gives an update on the current state of affairs under the Trump administration in regard to federal funding and regulations for insurance coverage plans. Watch now to hear the latest news. 

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:                    

Now, Congress is also trying to work on this, and I know, for instance, with the Affordable Care Act, there was money taken away from raising awareness of it for people to be recruited, to know, and there is legislation pending to try to restore that, right? 

John Wylam:                          

That’s correct. So, we refer to that as ACA outreach and enrollment funding, and the Trump administration had slashed that funding last year. And so, that’s not ideal because we need this funding to help the state exchanges enroll people in health plans. And when you’re dealing with health insurance, the more people you have enrolled in a health plan that usually means that the cost is going to be cheaper for all the enrolled in these.                          

So, when you’re taking this money away and you’re preventing people from signing up, what you’re doing is actually increasing the cost for everybody else. And so, we’re paying very close attention to this. So, we’re hopeful that some legislation can make it across the finish line that restores that funding.

Andrew Schorr:                      

Okay now, there's something else going on, too. There have been some of these association plans, which I don’t – maybe you could explain it. But the concern was, would this again siphon off people from the ACA, right? 

John Wylam:                           

Correct. So, it’s the same concern, and these are just different types of plans. So, the Trump administration has taken a regulatory action over the past couple of years to expand access to and the availability of association health plans and short-term plans. So, an association health plan is usually formed by bringing together a lot of smaller employers who don’t necessarily have the number of employees themselves to require them to have their own insurance plan. 

They’re not a larger corporation like other organizations so they’ll branch together in what are called “associations,” and they’ll negotiate together on the health plan that they’re gonna offer their employees. And so, what the Trump administration did is that they made these plans more available to consumers, they loosened the restrictions on them. And the reason that’s troublesome is that these plans sort of exist outside of the Affordable Care Act and they’re not required to cover all of the same benefits that ACA plans are required to cover. 

So, a consumer could unknowingly enroll in one of these plans and think that they have comprehensive coverage, and it turns out that they don’t. So, there’s a lawsuit going on to decide the validity of these plans and the regulations that enable them. And just recently, a district court judge, John Bates, struck down a federal regulation to allow for the expansion of association health plans, and that's kind of left states wondering about what the legal status is of those plans moving forward. And just earlier this week, the Department of Labor appealed that decision. And so, we’re watching very closely to see how that’s resolved. On the short-term plan piece...

Andrew Schorr:                      

...go ahead. 

John Wylam:                          

 For the short-term plan piece, it’s a similar issue, but Congress is trying to resolve that with legislation instead a lawsuit. So, it’s just dealing with the different political dynamic.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on June 13, 2019