America’s Health Insurance Plans (AHIP) is using its annual meeting in Seattle as a chance to try to push the focus of health reform efforts past questions about whether HealthCare.gov is working today. AHIP — a group that has been trying to offer big ideas for shaping health system change ever since it was formed through a merger of two older health insurer groups — is bringing thousands of health insurance company executives, technology company executives, data analysts, marketers and health policy specialists to Seattle this week for the AHIP Institute 2014 meeting.
The meeting is the first annual meeting AHIP has held since major Patient Protection and Affordable Care Act (PPACA) commercial health insurance market rules took effect and the PPACA exchange system jolted to life. Speakers are releasing data on the recent performance of public exchanges, private exchanges, and the health plans created and drastically revised by PPACA.
The state of Minnesota, for example, released data from University of Minnesota researchers who found that the number of Minnesota residents who are uninsured has now fallen to 264,000, down 40 percent from the number of people who lacked coverage Sept. 30, 2013 — before the PPACA exchange system opened for business.
AHIP itself has released a package of proposals with the title “Continuing Our Commitment to Consumers.”
PPACA created five “metal levels” of coverage — platinum plans, gold plans, silver plans, bronze plans, and, for some consumers, low-actuarial-value catastrophic plans that health policy specialists have dubbed “copper plans.” PPACA now prohibits the young consumers and other consumers who are allowed to buy the catastrophic plans from using PPACA premium subsidies to pay for the coverage.
AHIP is encouraging Congress to add another type of low-premium catastrophic plan aimed at individuals and families with moderate incomes. Consumers would be able to use PPACA premium subsidies to pay for the coverage.
AHIP also is responding to complaints that PPACA-related provider switching is affecting the ability of consumers with health problems to keep the providers who are overseeing their care. The group says members want health plans to support continuity of care during a 30-day transition period while patients are undergoing an active course of treatment, such as chemotherapy, for serious illness.
Member plans also want to offer access to at least six weeks of post-partum care for women in their second or third trimesters of pregnancy, and 30 days of advance notice before enrollees will face “formulary changes,” or changes in the lists of the prescription drugs a plan covers. AHIP plans are also insisting that doctors and hospitals should do a better job of warning patients when the patients are getting care out of network, especially after the end of a continuity-of-care period.
The plans say providers should refrain from “balance billing” consumers — billing consumers for the difference between the amounts paid by insurers and care providers’ full rates — during coverage transition periods.
AHIP President Karen Ignagni said in a statement that health insurers believe that “affordability, stability, and accessibility are top of mind for consumers when it comes to their health care.”
“We intend to work with all stakeholders to provide consumers with greater peace of mind in the new marketplace,” Ignagni said.