Commentary

GOP health care proposal would hike premium costs for half a million North Carolinians

The Republican Congress’ plans to repeal and replace the Affordable Care Act (ACA) have started to come into focus following the release of a policy brief and the leak of draft legislative language. Their proposal would eliminate the ACA’s premium tax credits and replace them with flat tax credits, which would operate like a voucher, for people buying their own insurance. These changes are important for people in our state, as 499,178 North Carolinians enrolled in a plan with financial help from the ACA’s premium tax credits in 2016.

While the GOP tax credit proposal is similar in a few ways to the ACA’s premium tax credit, it differs significantly in how it determines how much financial help an individual can receive. The dollar-amount of the GOP tax credit is adjusted for age, but it is not adjusted for crucial factors, meaning it will fall short of helping the people who need it most.

  1. There is no income test for tax credit eligibility, nor does the size of the tax credit adjust for people with lower incomes. Under this proposal, Art Pope could get a larger tax credit than a 30-year-old teacher.
  2. Second, the tax credit does not adjust for the costs of plans available to the consumer.

As a result, North Carolinians who are older, have low-to-moderate incomes, and have high health care needs would face unaffordable costs under the GOP proposal.

For a Greensboro family of four—two 35-year-old parents with two young children—that earns $65,000 annually, premium costs for a Silver plan would jump by 73 percent. In order to afford a decent health care plan, this middle-income family would have to pay roughly 15% of their income toward premiums alone.

Young people with much lower incomes would also see higher costs. A 33-year-old single mother of two children who makes $26,000 a year in Orange County would see her premium increase by a whopping 490 percent. Read more

Commentary, Trump Administration

Speak bigly, carry a small pen: Trump’s executive order on the Affordable Care Act

Donald Trump speakingOn his first day in office, President Trump signed an executive order targeting the Affordable Care Act (ACA). Since then, much as been made about what the executive order might mean. Because Congress has failed to come up with a repeal-and-replace plan as expeditiously as promised during campaign season, it seems that the executive order seeks to say a lot without doing very much in the short term.

Unfortunately, media coverage of the executive order has served the President’s goals—to confuse the public and subvert confidence in the law. Much like the congressional votes earlier this month to pass a budget resolution starting the process of repeal, the executive order has no impact on policy and makes no immediate changes to the law. What’s more, while the order makes references to curbing “economic and regulatory burdens” of the law, it grants no new authority to executive agencies. Any proposed changes—such as eliminating the individual responsibility provision of the law and others—would have to come through normal regulatory or legislative channels.

But here’s what the order does do: it signals the administration’s commitment to dismantling the gains that we’ve seen under the ACA. What’s more, it irresponsibly signals an urgency to undo the ACA without first enacting a plan to replace the law.

That’s dangerous for not only millions of Americans who benefit from the law, but it causes chaos for the insurance market. Insurance companies will have to apply to sell 2018 Marketplace plans by May; why commit to selling plans for 2018 if the Trump administration is not committed to maintaining a stable market? That’s especially true if the GOP pursues a reckless repeal-and-run strategy, seeking to repeal the law, delay the effective date, and come up with a replacement plan later.

Therefore, while largely symbolic, the executive order jeopardizes market confidence, which will likely contribute to an exodus of insurers from both the Marketplace and the non-Marketplace individual market. Think having only Blue Cross plans in every county is bad? Wait until no one is willing to sell.

At the end of the day, the ACA is still the law of the land, and consumers can continue to sign up for 2017 coverage until Open Enrollment ends next week on Tuesday, January 31. Don’t let the administration’s distractions fool consumers into thinking that enrolling is futile—financial help is still available, and most people are still required to have coverage. North Carolinians should enroll while they still can.

Commentary

ACA call-in day: Advocates telling Congress to “protect our care”

Congress may vote this week to start unraveling the Affordable Care Act (ACA). Even worse, as today’s edition of the Weekly Briefing explains, GOP leaders want to repeal the law without presenting a replacement plan. Not only would over a million North Carolinians lose health insurance coverage under this proposal, repealing the ACA would be a job-killer: North Carolina would lose 76,000 jobs and $1.2 billion in state and local revenue. All the while, repeal would give away a big tax cut to millionaires.

Defenders of the law, however, are pushing back. Today, for instance, has been designated as a “National #ProtectOurCare Call-In Day to save the Affordable Care Act.” People across the country are making phone calls to their elected representatives via the number below to tell them to vote against the plan to take health care and jobs away from North Carolina.

 Call 1-866-426-2631 to contact your U.S. Senators today!

Proponents of repeal, of course, claim that they will replace the ACA with “something even better,” but so far, such claims have proved completely illusory. Here in North Carolina, therefore, the message being delivered to members of Congress is simple and straightforward:

“Repealing the Affordable Care Act would hurt North Carolina’s economy and our citizens’ health. Repeal would:

  • Kill tens of thousands of jobs in our state.
  • Cause one million North Carolinians to lose coverage, and
  • Hurt our struggling rural hospitals.

This is a matter of life and death. Please vote NO on any legislation that repeals the Affordable Care Act.”

Supporters of the ACA are also being asked to sign their names to a petition: Tell Congress “no repeal without replace.” You can read lots more on the ACA, by clicking here to visit the Justice Center’s Health Advocacy Project website.

Commentary

What headlines are missing about Blue Cross’ premiums in 2017

Premium tax credits will lower sticker prices for most North Carolinians

Late last week, Blue Cross Blue Shield of North Carolina announced that its requested Marketplace premium increases had been approved. The plans it will sell on the Marketplace in 2017 will see an average increase of 24.3% in premiums. However, media headlines like this one are misleading—North Carolinians aren’t likely to see that kind of increase in their premiums in 2017.

Here is why the 24.3% figure is misleading:

1. It refers to the plans’ sticker price premiums. But 91.5% of North Carolinians with Marketplace coverage in 2016 qualified for financial help that provides a discount on sticker prices. Premium tax credits protect enrollees from annual increases, meaning that if premiums go up, tax credits go up to make up the difference.

2. This figure is an average increase spread out across Blue Cross’ Marketplace plans. Not every plan will see a 24.3% change to its premiums.

North Carolinians deserve to know how the health care news of the day affects them personally. Ultimately, consumers are better off ignoring media headlines and political pundits. Instead, they should check out their options on HealthCare.gov when Open Enrollment begins on November 1. And they can schedule a free appointment with an expert in-person assister who can help them understand their options.

This infographic from Blue Cross explains how premium tax credits protect a consumer from annual premium increases.

This infographic from Blue Cross explains how premium tax credits protect a consumer from annual premium increases.

Commentary

What Blue Cross needs to do to rebuild its reputation after $3.6M fine

Blue CrossYesterday afternoon, the North Carolina Department of Insurance (DOI) announced that it fined Blue Cross and Blue Shield of North Carolina (BCBSNC) a record $3.6 million for its customer service failures, which were brought about by technological problems the company experienced earlier this year. Prior to issuing the fine, DOI received thousands of formal complaints in which North Carolinians from across the state noted:

…that BCBSNC customer service department was not readily available by telephone or through their website; that consumers did not receive valid identification cards or proof of coverage; that consumers experienced problems in billings and crediting of premium payments; that consumers experienced incorrect policy cancellation notices and difficulty obtaining premium refunds due; and that consumers did not receive timely notices of renewal of their policies with explanations of coverage changes.

In the agreement it signed with DOI, the nonprofit insurance company acknowledged it fell short of expectations, noting that it “…failed to timely provide identification cards, experienced errors in invoices and billing, and failed to respond to the NCDOI on a timely basis in early 2016,” which resulted in disruptions for thousands of consumers across the state. BCBSNC has attributed these problems to technology failures that the company claims have been corrected.

DOI did the right thing by levying this fine, signaling that there are consequences when an insurer makes mistakes that jeopardize consumers’ health and finances. Although the Department has concluded its investigation into BCBSNC, there are actions that the company can take to ensure that it does right by the people of North Carolina. Clearly, Blue Cross must ensure that its IT systems are indeed problem-free in advance of the next Marketplace Open Enrollment Period starting on November 1, 2016.

But the most important thing that Blue Cross and Blue Shield of North Carolina can do to honor its commitment to the people of this state is to serve North Carolinians in all 100 counties of the state on the Health Insurance Marketplace in 2017. In comments made last week, CEO Brad Wilson hedged when asked whether the company would do so next year, citing concerns about health care costs and onboarding customer service staff. But given that the ACA business is a relatively small part of the company’s overall portfolio and that the company was deemed “profitable” and in good financial health last year, BCBSNC ought to do the right thing.

After all, Blue Cross and Blue Shield of North Carolina’s mission is “[t]o improve the health and well-being of our customers and communities.” If they truly want to improve the health of our communities, they’ll prepare to serve all of our communities.