AMA Adopts New Policy Leading to More Affordable ACA Marketplace Plans

The AMA House of Delegates announced at the 2018 AMA Annual meeting the adoption of a new policy that will help make ACA marketplace plans more affordable in order to increase the number of members covered. The new policy also opposes the sale of individual and small group policies that do not guarantee preexisting condition protections and coverage of essential health benefits. 

“We must build on the gains of the Affordable Care Act and make coverage more affordable for Americans by extending the eligibility for premium tax credits and increasing tax credit amounts for young adults that will result in greater coverage,” AMA President David O Barbe, MD, MHA, explained.

According to the AMA, the new policy will improve affordability in the health insurance exchanges by: 

• Providing adequate funding for and expansion of outreach efforts to increase public awareness of advance premium tax credits;
• Expanding eligibility for premium tax credits up to 500% of the federal poverty level;
• Providing young adults with enhanced premium tax credits while maintaining the current premium tax credit structure which is inversely related to income;
• Encouraging state innovation to maximize the number of individuals covered and stabilize health insurance premiums; and,
• Establishing a permanent federal reinsurance program.

In order to balance the individual market risk pool, an AMA Council on Medical Service report explained that there is a need for outreach to increase the number of patients insured. Further, the report noted that there is a concern that the elimination of the federal individual mandate penalty may cause premium increases, coverage losses, and market instability. 

“The AMA knows that insurers are more likely to participate in marketplaces with large and healthy risk pools,” Dr Barbe said. “We need to take steps to ensure that healthy individuals stay enrolled in coverage offered in the ACA marketplaces.”—Julie Gould