Healthcare Guaranteed Benefits Pool Would See Dramatic Premium
Reductions and Encourage More Louisianans Get Insured
Insurance
Commissioner’s Report Shows Lower Plan Premiums, Guaranteed Coverage for
Pre-Existing Healthcare Conditions as a Result of Act 412
BATON ROUGE, LA – Today, Louisiana Commissioner of
Insurance Jim Donelon delivered to the Legislature his initial report on
beginning the implementation of Act 412 - the Health Care Coverage for
Louisiana Families Protection Act, bipartisan legislation pushed by Attorney
General Jeff Landry to protect patients with pre-existing conditions should
federal courts continue to rule the Affordable Care Act (ACA) unconstitutional.
Among the key findings in the Insurance
Commissioner’s Report:
* The Guaranteed Benefits Pool will reduce
individual market healthcare premiums by a dramatic 35%-45%. This is a massive
savings especially in light of the fact that ACA plans in Louisiana have had an
overall price increase trajectory equaling 14.6% per year - on average - from
2015-2019, including nearly 33% in 2017 alone.
* The average health insurance premium reduction
will be $300 per month less than current ACA rates. This is a savings of $3,600
per year - on average - for those with current individual ACA plans.
* The premium reductions will result in
encouraging a portion of Louisianans, specifically those currently unsubsidized,
to return to the individual market and become insured. This will increase the
rate of insured in Louisiana.
* Access to coverage for Louisiana patients with
pre-existing conditions is guaranteed along with other essential health
benefits.
* More young people will enroll in coverage with
the change in age rating, again increasing the number of insured.
* With a likely flattening of the age curve with
full implementation and the dramatic savings resulting from the pool, older
citizens could - and should - see savings.
* The cost to implement the Guaranteed Benefits
Pool is less than half of current federal taxpayer-funded ACA subsidies being
sent into Louisiana.
* Utilizing the ACA-budgeted subsidy money
currently sent to Louisiana as a federal block grant would cover not only the
cost of the Guaranteed Benefits Pool but also likely provide enough funding to
subsidize or provide healthcare benefits for current low-income ACA enrollees.
“This report confirms what we believed when the
Legislature, almost unanimously, passed Act 412: this bi-partisan law will
protect individuals with pre-existing conditions while lowering health
insurance premiums,” said General Landry.
“Louisianans currently in ACA plans will save thousands
each year in their healthcare premiums,” continued General Landry. “This report
details savings are possible not only in premiums but also in federal taxpayer
overhead needed to administer the ACA from Washington. We can accomplish this
without a so-called 'age tax' or a 'giveaway to the rich' as critics would
falsely claim.”
“The Maine model, on which Act 412’s foundation was
based, saw premium savings for older citizens; we expect the same in Louisiana
due to the dramatic overall average monthly premium savings,” added General
Landry.
It is important to note that Act 412 was designed as a
state-based solution for those enrolled in current ACA plans. “Like the ACA, our Act 412 does not at all impact senior citizens who rely upon Medicare. It is
critical for senior citizens to know their Medicare benefits are not impacted
at all by the ACA or Act 412; they remain protected and untouched,” concluded
General Landry. “Also, those who receive insurance from their workplaces are
also not impacted.”
Act 412 prohibits the denial of healthcare insurance for
pre-existing conditions; eliminates lifetime limits on the dollar value of
benefits and prohibits annual limits on the dollar value of essential benefits;
allows for healthcare coverage on parent policies for any child until the age
of 26; and ensures that any healthcare plan provide for essential health
benefits including ambulance care, emergency services, maternity and newborn
care, hospitalizations, pediatric care, and prescription drugs among others.
To address the needs of those who are low or moderate
income and receive coverage subsidies under the current ACA, Commissioner
Donelon and General Landry both support a variety of possible solutions. These are
outlined in the Department of Insurance’s report. General Landry has suggested
that one solution would be to use a portion of the cost savings of higher
income individuals for those at lower incomes - in addition to the remaining
federal dollars through a block grant of current ACA subsidy funds. If this
limited recapture of savings occurred, those at low and moderate income would
stay insured while those who are unsubsidized would still experience a
significant price savings each month. The Department of Insurance summary
report includes this option. Act 412 is designed to benefit all Louisianans,
not just those who are unsubsidized.
Act 412 passed the Louisiana Senate 38-0 and the
Louisiana House 90-9, and it cleared the House Insurance Committee and the
Senate Health and Welfare Committee without opposition.
Act 412 does not address Medicaid Welfare as the welfare
program has been in existence since 1965 as a federal program, only
administered partly by the State. The Attorney General expects that Congress
and the President will continue to support this program, post ACA. Following
the ACA, it is the Attorney General’s hope this can be done with more
flexibility to the states to create innovation and reduce costs. President
Trump has already introduced programs that signal his desire to give states
greater flexibility over providing health care to their low-income populations
in a more efficient and effective way. A continued push to stop welfare fraud,
part of General Landry’s responsibility in Louisiana, is also important when
looking at any changes to this federal program.
#
