What important healthcare changes were part of the discussion at this year’s NAHU Capitol Conference? 

It wasn’t all about “Medicare For All” programs. There are lots of other bills and rulings that will either help or hurt our clients and our free market system. That’s why I joined 700 or so NAHU colleagues in Washington D.C. last week. As a group, we met with virtually every congressperson’s office. 

Curious what our consistent advice was? Here are our top 5 requests for 2020 health reforms…

1. Stop Surprise Billing

Balance billing is allowed in many contracts in our industry. This practice can be a nightmare for patients and becomes one for providers as news outlets pick up “surprise billing” stories of patients in cases of emergency, involuntary care, or other instances when a person has no choice in choosing the provider. 

We need to help solve this. A few tactics include: 

• Prohibit balance billing in these instances 
• Require notice to patients about provider network status and options
• Prohibit excessive bills by applying that geography’s median in-network rate in these cases
• Don’t burden the process by building in a cumbersome and expensive arbitration system

2. Improve Medicare

Changes to Medicare rules come down from on high – even very sensible-sounding changes. Improvements we recommended this year include the following:

• Allow COBRA coverage to count as creditable coverage for Medicare beneficiaries, giving them access to Part B on a timely basis without penalties for late entry
• Apply “observation” time in a hospital toward the necessary three-day hospital stay prior to entering a nursing home 
• Allow working Medicare beneficiaries to contribute toward their HSA

3. Stabilize Healthcare Markets

Every year we give input to legislators on tweaks to improve individual and group costs and risk pools. Input this year included:

• Preserve the employer tax exclusion for employee benefits. In recent years, many politicians have gotten excited when they see billions of dollars not paid in taxes by employers, viewing it as a pool of money to fund other projects. But eliminating or capping the exclusion would be detrimental to the stability of the employer-based market. 
• Support a set of bills that establish a new approach to employer reporting. Ease reporting provisions with a new voluntary reporting system that reduces the number of individuals, shrinks the amount of information required, and eliminates the collection of dependent SSNs. 

4. Don’t pass a “Medicare For All” or a public option plan

A one-size-fits-all government-run system would shut down all existing independent health plans, and in fact would shut down Medicare. Additionally, it would cost $32 Trillion, reduce the standard of care, shrink access to care, and increase taxes by $24,000 for the average household. For more info on how to discuss this with clients, click here to watch our recent webinar along with a few other resources to help make you sound brilliant when talking about this. 
An alternative plan that sounds harmless is for the government to build and run a “public option plan” or a “Medicare Buy-In plan”. But it’s not a harmless individual plan because it:

• Sets a precedent of paying providers at Medicare rates (or lose their Medicare contract)
• Could put more than 1,000 rural hospitals at risk of closure
• Compounds financial stresses already facing hospitals
• Directly competes with individual plans of carriers with unfair pricing rules that put them at risk of losing members
• Could ultimately lead to a complete loss of the private individual market

5. Celebrate Two Big Fixes

Since the ACA passed 10 years ago, we’ve consistently asked Congress to repeal the Cadillac Tax and the HIT Tax. They finally did so at the end of 2019. Either of these taxes would have dramatically increased employer and member costs, thereby destabilizing the free market. It’s great to see when level heads prevail!

Most of our year is focused on serving individual employees within our employer clients. I love how practical it is to directly impact the care of their lives. But it’s very empowering to invest a few days every year helping to rebuild our system from a very macro-economic viewpoint. 

If you agree, it’s time to join NAHU and support this industry that’s supporting our free-market system (click here, and say I referred you). Then come join us in D.C. next year!

Now it’s your turn! Which of these do you see as most critical? What other issues would you speak to congressmen and women about? Comment below or email me at reid@freshbenies.com.