Now that the debate on the “repeal and replacement” of Obamacare is in the hands of the U.S. Senate, the question becomes, what will happen next? Which version of the AHCA will become the law of the land. To get a very good perspective on what challenges that the Senate has to craft an effective legislative solution, please read the following article from the NPR.
http://www.npr.org/2017/06/05/531221275/the-senates-4-big-problems-with-health-care
There are some folks who believe that the whole idea of regulation of Health care should be a state and not Federal responsibility. For a good primer on the concept, have a look at the following links.
Some states have started looking at alternatives to Federal control of Health Care. Some states like California have proceeded with legislation to create a state run single payer solution for all. There of course are a myriad of opinions and issues with this type of solution. Here are a couple of pretty interesting takes on the concept.
http://dailysignal.com/2017/05/30/california-pushes-forward-400-billion-universal-health-care-bill/
http://www.modbee.com/opinion/state-issues/article155073799.html
Another alternative concept in this debate is to allow states to offer residents the option to buy their healthcare insurance via the existing Medicaid system. Medicaid provides low-cost care to millions of the nation’s oldest, sickest and most vulnerable populations.
In 2013, a report by the Urban Institute states (https://kaiserfamilyfoundation.files.wordpress.com/2013/05/8440-what-difference-does-medicaid-make2.pdf) that if an average adult on Medicaid had traditional private insurance instead, the cost of care would be over 25 percent higher. The concept is to eliminate the insurance exchanges while allowing exchange beneficiaries to buy into Medicaid, using tax credits to pay the premiums. Recent surveys showing that Medicaid beneficiaries are generally satisfied with their coverage, more so than their exchange counterparts, makes the case even more persuasive.
For a full read on this concept, please see the following article in the New Your Times.
https://www.nytimes.com/2017/05/18/opinion/obamacare-repeal-medicaid.html?_r=0
The state that has started down this path the furthest is Nevada with the passing of A.B. 374 (https://www.leg.state.nv.us/Session/79th2017/Bills/AB/AB374_R1.pdf). This bill which is waiting for signature by Nevada Gov. Brian Sandoval is based on the concept that because states have a large role in running Medicaid, they can move these proposals forward with less involvement of the federal government and would be controlled by Carson City not Washington.
The buy-in coverage would be pretty much identical to the coverage traditional Medicaid provides, although it would not cover emergency medical transportation (a benefit of the program tailored to the low-income population it traditionally serves). This bill has a long way to go before it becomes the law of the land (including getting a Federal “waiver” to demonstrate the value of it) but in the Health Care Debate, anything alternative is worth debating. For information more information on this bill, please read:
https://www.vox.com/policy-and-politics/2017/6/6/15731622/nevada-medicaid-for-all
http://www.latimes.com/nation/la-na-nevada-health-coverage-20170607-story.html
Or if you want to listen to a discussion on its merits, please click on the following link.
http://kjzz.org/content/487913/nevada-legislature-passes-medicaid-all-bill
In conclusion, it is certainly not clear what the landscape of Health Care Insurance will be in the future but concepts such as “Medicaid for all” are interesting alternatives to be considered.
No matter what benefits and how are provided, the need to communicate those enrollments quickly and efficiently to insurance companies will be an ongoing need. SoftCare’s EnrollmentPlus was designed by an Advisory Council of industry enrollment experts to facilitate the easy implementation of electronic enrollments from Employer Groups through Enrollment Vendors to Insurance Carriers. Call us for more details on click on https://softcare.cominsurance-plans/ on how EnrollmentPlus can fit into your electronic enrollment architecture.
Mike Cobban
Mike.cobban@softcare.com
Director of Operations and Support
SoftCare Solutions | A Division of MTBC