Testimony by Margaret Murray, CEO, ACAP to the Senate Committee on Health,
Education, Labor & Pensions
Full Committee Hearing: Stabilizing Premiums and Helping Individuals in the Individual
Insurance Market for 2018: Health Care Stakeholders
September 14, 2017
Chairman Alexander, Ranking Member Murray, and Members of the Committee:
The Association for Community Affiliated Plans (ACAP) thanks you for the opportunity to comment on the Committee’s efforts to stabilize the Marketplaces. ACAP is an association of 60 not-for-profit and community-based Safety Net Health Plans (SNHPs) located in 29 states. Our member plans provide coverage to more than 20 million individuals enrolled in Medicaid, CHIP, Medicare Special Needs Plans for dually-eligible individuals, and the Marketplaces. In 2017, seventeen of ACAP’s SNHPs offered qualified health plans (QHPs) to over 700,000 enrollees in the Marketplaces.
Looking to 2018, ACAP’s SNHPs are in an untenable position of facing significant uncertainty. As historically Medicaid-focused plans working to improve the health and well-being of lower income and vulnerable populations, ACAP’s plans are committed to remaining in the Marketplaces wherever possible. Many ACAP plans are part of integrated delivery systems with robust safety net provider networks including public hospitals, children’s hospitals, and community health centers. As such, SNHPs are uniquely situated to manage care for Marketplace enrollees—many of whom churn between Medicaid and the Marketplaces as income levels fluctuate. ACAP members have also stepped up to fill the bare counties in at least
However, because of the significant uncertainty facing the Marketplaces, three ACAP plans have announced plans to withdraw their QHP products altogether. Still others are waiting to see what happens in Washington before signing their final QHP agreements on September 27th, 2017. Their final decision will likely be determined by the outcome of this Committee’s efforts as well as ongoing guidance from the Administration. To date, the constant uncertainty around rules moving forward is the single biggest hindrance to plan participation, and those that have left the Marketplaces have stated they would like to re-enter in the future, once there is greater stability. As Medicaid plans owned in many cases by safety-net parent companies, the risk 2 posed by current instability is simply greater than they can take on without endangering their Medicaid lines of business.
Accordingly, ACAP has developed the following set of recommendations to stabilize the individual market for the Committee’s consideration.View the full article »