Commonwealth brief addresses potential for abrupt changes in financial responsibility and gaps in health insurance coverage under ACA
Posted on May 31, 2011 | No Comments
The Affordable Care Act (ACA) builds on existing sources of public and private health insurance, while creating new health insurance Exchanges and subsidies. A potential disadvantage of maintaining multiple sources of health insurance is the likelihood of abrupt changes in coverage or financial responsibility when individual circumstances change. The Commonwealth Fund brief, “Realizing Health Reform’s Potential: Maintaining Coverage, Affordability, and Shared Responsibility When Income and Employment Change,” describes four policy challenges related to such abrupt changes: 1) adjusting premium and cost-sharing subsidies when incomes change; 2) coordinating eligibility for premium credits, Medicaid and the Children’s Health Insurance Program (CHIP); 3) encouraging and facilitating continuous coverage; and 4) minimizing transitions between individual and small-business exchanges. The brief outlines several policy recommendations to reduce uncertainty, simplify coverage decisions, and minimize insurance transitions. These policy change suggestions include extending coverage to the open enrollment period at the end of the year, generous treatment of income gains in correcting premium tax credits, and unifying the small-business and individual exchanges.