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Analysis

Large Employer Groups Send Congress Healthcare Recommendations for Pandemic Response

By Jack O'Brien  
   May 19, 2020

The four main employer groups behind the letter are the American Benefits Council, The ERISA Industry Committee, the National Alliance of Healthcare Purchaser Coalitions, and the Pacific Business Group on Health.

Several large employer groups sent a letter to congressional leaders Tuesday morning offering recommendations to ensure access to "high quality, affordable healthcare" during the ongoing coronavirus disease 2019 (COVID-19) pandemic.

The main recommendations included in the letter are "affordable coverage in the immediate and longer term," access to primary care physicians, a halt to price gouging and surprise billing, and mitigation of risk in the insurance market.

The four main employer groups behind the letter are the American Benefits Council, the ERISA Industry Committee, the National Alliance of Healthcare Purchaser Coalitions, and the Pacific Business Group on Health (PBGH).

"The pandemic has placed unprecedented strain on our country’s healthcare payment and delivery systems," the letter read. "As Congress and the administration grapple with this rapidly evolving and highly destructive crisis, we urge policymakers to contemplate immediate and longer-term coverage policies as separate and distinct."

The letter was co-signed by over 30 groups, including the Leapfrog Group, Partnership for Employer-Sponsored Coverage, and Self-Insurance Institute of America, Inc.

Related: PBGH CEO on Sutter Health Antitrust Settlement: 'I Don't Think This Issue Will Go Away'

The employer groups detailed specific recommendations to address coverage concerns, including bolstered subsidies for individuals receiving healthcare access through COBRA, increased access to telehealth services, and long-term health coverage that includes cost containment measures.

To ensure access to primary care physicians, the employer groups called on Congress to mandate that providers commit to not engaging in M&A activity for 12 months as part of receiving funds through the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

"These reforms are especially critical to ensuring the long-term viability and survivability of smaller physician practices," the letter read. "As these smaller practices struggle and threaten to close because of this pandemic, we fear this could exacerbate already problematic provider consolidation – giving even more market domination to physician staffing firms and other parties already positioned to command exorbitant prices."

The employer groups also urged Congress to prioritize efforts to protect patients from high costs during the pandemic.

These include a ban on "price gouging on any health care items or services," the enactment of a "local, market-based payment rate" to curb surprise billing, and the passage of policies that protect both payers and employers from "unexpected costs in the 2020 and 2021 plan years."

Related: KFF Study: 26.8 Million People Could Lose Employer Health Coverage in Downturn

The economic upheaval caused by the pandemic has challenged employers dealing with unprecedented pressures to the bottom line, especially as it relates to healthcare costs going forward.

Earlier this month, a Willis Towers Watson (WTW) analysis projected that the COVID-19 outbreak might reduce healthcare costs for employers by as much as 4%.

WTW estimated that at a 10% infection level, benefit costs could rise by 1% to 3%, while a 30% infection level could see costs rise by 4% to 7%. At the highest rate included in the analysis, a 50% infection level, costs could rise between 5% to 7%.

Days before that report was released, the American Hospital Association, America's Health Insurance Plans, and the U.S. Chamber of Commerce sent a letter to congressional leaders that called on them to protect and expand health coverage for employers and workers.

Related: AHA, AHIP, & U.S. Chamber of Commerce Call on Congress to Expand Coverage Options During Pandemic

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

"As Congress and the administration grapple with this rapidly evolving and highly destructive crisis, we urge policymakers to contemplate immediate and longer-term coverage policies as separate and distinct," the letter read.

The employer groups called on Congress to mandate that providers commit to not engaging in M&A activity for 12 months as part of receiving funds through the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Other recommendations included a ban on "price gouging on any health care items or services" and the enactment of a "local, market-based payment rate" to curb surprise billing.


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