On Health Care Policy, We All Agree: Let’s Protect Patients

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While the daily monitoring of health policy developments shows deep rifts between the political parties in courts, Congress, and state legislatures, it is important to focus on the many areas of consensus.

Most leaders from both sides of the aisle support governmentally-subsidized health insurance coverage for those over 65; those made vulnerable by disability; and those who cannot afford the cost of private insurance. They agree that we have a responsibility to those who are vulnerable to provide them with access to the care they need. They agree that those who serve our nation in the armed forces should be provided the best possible care while on duty and as veterans.

This year, it has become clear that this consensus extends to meaningful protections in the individual insurance market. For instance, President Trump in asserting that the Republican Party “will soon be known as the party of healthcare” pledged his strong support for protecting those with pre-existing conditions. The parties should work together now to make sure that these protections remain in place regardless of the outcome of pending litigation.

According to Gallup, 27 percent of U.S. adults say they personally have a long-term medical condition, illness or disease that an insurance company would consider a pre-existing condition. And 75 percent of respondents to a Kaiser Family Foundation poll state that it is “very important” that the Affordable Care Act (ACA)’s provisions that prohibit health insurance companies from denying coverage because of one’s medical history remains law. Additionally, 95 percent of U.S. employers believe Congress should preserve coverage for pre-existing conditions should the Affordable Care Act be overturned.

If repeal of the pre-existing condition exclusion would be devastating, outright repeal of the ACA would be worse, negatively impacting over 20 million people who are now covered on the individual insurance market or through expanded Medicaid programs. The Urban Institute estimates that eliminating the Affordable Care Act in full would cause the uninsured rate to increase by at least 65 percent. The number would spike from the roughly 30 million uninsured today back to the numbers seen before the ACA – over 50 million. Most of these additional 20 million people will have chronic health issues, leading to exclusion from insurance based on pre-existing conditions.

I urge the administration and Congress to work together to enact some agreed-upon priorities where there is consensus in the provider community, including:

  • Reducing the prices of extremely expensive medications.
  • Easing unnecessary regulations that increase burden and hinder transformative progress.
  • Removing barriers to the critical transformation of our health system from paying for the volume of services to paying for the value of care delivered.
  • Protecting patients with pre-existing conditions.

And, if the experience of the ACA has taught us one thing, it is that legislating on health care is a very difficult task even when leaders have agreement on specific policies. Some in the administration have asserted that should the protections against pre-existing conditions exclusions be eliminated by court order that they would re-enact such protections in some legislative form. However, if leaders really do agree with protecting those with pre-existing conditions, then they should develop a strategy for continuous protection of those with pre-existing conditions before any court decisions on the ACA are rendered.

Achieving progress on these priorities would help patients, reduce costs, and increase efficiency in health care. Removing protections for those with pre-existing conditions, even if that is not the intent, will only hurt those we are called to serve.

Anthony R. Tersigni, EdD, FACHE, is Chief Executive Officer of St. Louis-based Ascension, a leading  Catholic health care system.

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