AHA, businesses and insurance providers send letter to Congress to keep Americans covered during the COVID-19 pandemic

April 28, 2020

The Honorable Nancy Pelosi                         The Honorable Mitch McConnell
Speaker                                                          Majority Leader
U.S. House of Representatives                      U.S. Senate
U.S. Capitol Building, H-222                           U.S. Capitol Building, S-230
Washington, DC 20515                                   Washington, DC 20510
 

The Honorable Kevin McCarthy                      The Honorable Charles E. Schumer
Republican Leader                                          Democratic Leader
U.S. House of Representatives                       U.S. Senate
U.S. Capitol Building, H-204                            U.S. Capitol Building, S-221
Washington, DC 20515                                    Washington, DC 20510
 

Dear Speaker Pelosi, Leader McConnell, Leader McCarthy and Leader Schumer:

Thank you for your swift action to help overcome the COVID-19 crisis. Your action is speeding support to hospitals, doctors, nurses, businesses and workers from critical investments in equipment to direct assistance to cover immediate expenses. More must be done, and we stand united in our commitment to work with you and to work together.

The magnitude of the COVID-19 crisis is extraordinary. It has taxed our health care system like never before, and it has stressed the economy as consumers and businesses limit commerce and adhere to social distancing to reduce the transmission of the disease. These actions have undoubtedly saved lives, but they also have cost millions of jobs – more than 26 million by the latest employment reports. Because nearly 180 million Americans get their health care coverage through their work, it is critical to ensure millions of Americans continue to have employer coverage.

That is why we urge you to take immediate action to support employers and workers by protecting and expanding high quality, affordable health care coverage. That includes our social safety net of unemployment insurance and Medicaid. These programs are struggling to keep up with the increased demand, and state budgets – a significant source of funding for these programs – are increasingly strapped due to loss of tax revenue. As a result, millions of individuals will join the ranks of the uninsured unless you act. Loss of health care coverage will create additional financial and emotional stress on individuals and families, reduce resources available to the health care system at a time where providers must increase capacity to address the COVID-19 surge, and stymie public health interventions that require routine engagement between individuals and the health care system.

Employers need more support – and workers need to be able to continue their stable, secure coverage. As you consider the next round of legislation to overcome COVID-19, we urge you to prioritize maintaining private health benefits for individuals and families and to increase coverage options for those who are already uninsured. Specifically, we urge you to:

• • Provide Employers with Temporary Subsidies to Preserve Health Benefits. Many employers experiencing loss of revenue as a result of the economic downturn are compelled reluctantly to reduce benefits as one way to manage expenses. Congress could help employers by providing subsidies to offset the cost of preserving health coverage during this crisis.
• • Cover the Cost of Coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA). The COVID-19 crisis has already triggered significant job loss. Many individuals may have the option to maintain their job- based health coverage through COBRA but find the costs to be prohibitive, especially if they are facing a significant reduction in income. Congress could offset the full cost of coverage through COBRA to former employees through a direct subsidy.
• • Expand Use of Health Savings Accounts (HSA). Currently, HSAs may only be used for certain qualifying expenses, which do not include premiums. Congress could temporarily lift this limit to provide individuals and families with access to additional resources to cover the cost of coverage.
• • Open a Special Enrollment Period for Health Insurance Marketplaces. The Health Insurance Marketplaces are an existing source of private coverage for many individuals and families, including those in self-employed households. While individuals who have recently lost employer-based coverage are eligible to enroll in the Marketplaces as a result of an existing Special Enrollment Period (SEP), Congress could create a new, one-time SEP for enrollment in the Marketplaces specifically for those individuals who are uninsured and not otherwise eligible for an existing SEP.
• • Increase Eligibility for Federal Subsidies for the Health Insurance Marketplaces. Some individuals and families earned too much money to qualify for Health Insurance Marketplace subsidies but too little to afford premiums. Congress could increase access to individual market coverage by increasing eligibility for federal subsidies. We also recommend that Congress temporarily enhance financial assistance for individuals who already rely on the Health Insurance Marketplace for coverage by reducing the required contribution percentage to lower the cost of premiums.

Additionally, the Department of Health and Human Services (HHS) is using a portion of the $100 billion added to the Public Health and Social Services Emergency Fund authorized by the Coronavirus Aid, Relief, and Economic Security Act to cover the costs of the uninsured. This approach will quickly deplete the Emergency Fund and not provide the benefits of comprehensive coverage, which include protections against preexisting conditions and establishing a regular connection between patients and care providers. The actions outlined above would be far more effective to stabilize businesses and strengthen health care coverage.