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Competition Drives Patient-Centered Care


 

Publisher's Note: As a monthly publication, the articles by Reps. Blackburn & Cooper were written before the House renewed its push for a vote on a revamped AHCA plan. Rep. Blackburn voted in favor of the new measure. Rep. Cooper voted against. While the bill passed in the House 217-213, it is far from a 'done deal.' The Senate now takes up the measure and has promised significant changes ... with some Republican lawmakers saying they will scrap the House version and start over. Changes to the AHCA will require the bill go back to the House ... and we begin again. We share this to say that the thoughts and remarks of our two esteemed guest columnists are still relevant and timely with healthcare reform an ongoing conversation.

Tennessee has been hit especially hard from President Obama's Affordable Care Act. Over 130,00 Tennesseans lost coverage last year, premiums have increased by up to 62 percent for many consumers and 73 of 95 counties have only one health insurance provider.

Last year, Cigna asked for and received a 46.4 percent premium increase, Humana, 44.3 percent, and BlueCross BlueShield of Tennessee, 62 percent. After seeing these numbers, it is of no surprise that the Tennessee Insurance Commissioner said the Obamacare exchange was "very near collapse" just last summer. There is quite obviously a lack of competition, keeping companies from competing for business across state lines and keeping consumers from shopping around for their best options at the most affordable price

Competition drives us forward. Whether it's in the context of a sporting event, your career, or business, competition makes you better and drives innovation. It's no different in the healthcare insurance marketplace where enabling consumers to choose between multiple products that adhere to their specific needs stabilizes the market. After all, individuals are far more suited to picking plans that work for them than the bureaucrats in Washington, D.C. This is why competition is necessary for driving quality care and better health outcomes.

The healthcare marketplace is distressed due to Obamacare and the limitations that exist from the individual mandates and absence of competition. Americans are tirelessly waiting for the federal mandates to be thrown out and the marketplace opened up, which is why I keep working on my legislation, H.R. 314, the Health Care Choice Act. This legislation would repeal Title I of the Patient Protection and Affordable Care Act and puts in place a policy that would allow for the purchase of health insurance across state lines. In other words, you can purchase what you want from wherever you want at a price you can afford. Unfortunately, that has not been the case, and I regularly talk with constituents who are more than ready for that to change.

Last year, I authored H.R. 706, the Plan Verification and Fairness Act, which called for the administration to follow their own law by providing verification for populations that were enrolling into the marketplace under a Special Enrollment Period (SEP). Under current law, to qualify for a SEP, a person must provide documentation that a life-altering event has occurred. These events could include: moving, birth, marriage etc. - all situations where proper documentation is provided; and the former administration refused to verify this information so that they could drive up the marketplace's enrollment numbers. This intentional oversight caused an imbalance within the marketplace and led to consistent abuse by gaming the system. It's like purchasing a new car, wrecking it, and then buying car insurance. Having this ability within the exchanges allowed for common abuse. Without implementation of my bill, this was a system that was allowed to fail. The Plan Verification and Fairness Act is a common-sense solution for a failing marketplace.

In 2017, my bill was implemented through rulemaking as part of the Market Stabilization Rule - and this effort resulted in a 100 percent pre-verification by the administration for Special Enrollment Periods. These solutions help those in areas like Knoxville where only one carrier remains. While this helps offer stability to the marketplace, having competition in place would help avoid future disruption.

Competition brings multiple options to you and allows you to make the choice, not the federal government or the insurance company. That is what patient-centered healthcare is all about. You have the power to review the options and select what is best for you. Businesses compete for your business and work to keep you as a customer. You are in charge.

Currently, if a consumer were to attempt to purchase individual health insurance, that plan is controlled by the individual states. Opening up the market would eliminate the specific state regulations to create more health plan options- regardless of state or location - providing flexibility to the consumer. Allowing for the purchase of health insurance across state lines changes the narrative. It takes healthcare coverage from a bureaucratic decision to an individual choice, stepping away from a "one-size-fits-most" plan that doesn't encompass the variation in consumer needs. 


Under Obamacare now, the federal government has overstepped its bounds in mandating what insurers' offer to their customers. The qualifications to fit the mandated health plan have, no doubt, limited how the health plans operate. This doesn't enable competition. It's obvious - if we continue to let the federal government take the lead in regulating individual choices, competition will be nonexistent. Therefore, it is imperative that we give both states and consumers flexibility in the options that exist when they're purchasing a health plan that will actually accommodate their individual needs.

The Health Care Choice Act will allow you to shop for health insurance like you would any other type of insurance: online, by mail, or over the phone. Enabling Americans to make their own choices is crucial, as we know they can determine the plan that will be tailored to their specific needs. The bureaucrats in Washington have no business trying to force individual healthcare needs into a cookie cutter plan.

Republicans have countless opportunities in the upcoming years to reform the federal government, but we have promised to fix our broken healthcare system. That's why I will continuously fight for H.R. 314 as a method to cut through the bureaucratic red tape and allow states, consumers, and providers the opportunity for patient-centered healthcare and competition.


As a small business woman, author, mother, grandmother, and Member of Congress, U.S. Rep. Marsha Blackburn (R-TN 7th District) has dedicated her service to making America a more prosperous place to live. Earning her start in the Tennessee State Senate, she quickly proved herself as a fighter when she defeated a proposed state income tax. Now serving as chairman of the Energy and Commerce's Subcommittee on Communications and Technology, she continues her diligence in working for Americans. For more information or to connect with Rep. Blackburn, go to blackburn.house.gov.

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Tags:
ACA, ACHA, Health Care Choice Act, Healthcare Reform, Insurance Reform, Market Stabilization Rule, Marsha Blackburn, Obamacare, Plan Verification and Fairness Act, SEP, Special Enrollment Period
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