Welcome back Congress

Congress returns from summer recess this week facing a full plate of healthcare issues. Fortunately, a number of proposals before lawmakers offer real solutions to concerns over costs and coverage gaps. There’s a short window for action, but the fall offers a refreshing opportunity for progress.

Blue Cross and Blue Shield companies are working with lawmakers in both parties to make sure policies support patients in getting care at the most affordable price and ensuring consumers get the information they need to make the best healthcare choices for their families while ensuring their personal health information stays secure and protected. Here is a look at some key priorities and recommendations to move healthcare in the right direction: 

Surprise Bills – No one who has taken the care to receive medical services within their health plan’s network should have to worry about receiving a surprise medical bill. Nor should Congress create a new system of costly and time-consuming negotiations to settle these crippling charges. We’re working to protect patients with fair, predictable payments to medical practitioners that will help keep costs down and not open the door to even higher prices and more complexity. We fact-checked the arguments on how to best solve the problem of surprise bills, separating the myths from the facts.

See our full recommendations to address surprise bills.

Transparency – As health insurer to one in three Americans, we know what consumers want most is clear information about their out-of-pocket costs, the quality of care they will receive and whether or not a clinician is in network. To be most beneficial, consumers need information within the context of their own health benefits, which is why Blue Cross and Blue Shield companies across the country have developed tools and resources to help consumers access and understand the individualized information critical to their personal healthcare decision-making. Efforts to improve healthcare transparency must focus on getting the right information to consumers at the right time, and in the way that’s most accessible for them, while making sure such efforts do not raise costs or jeopardize the privacy and security of consumers’ personal health information.   

See the Blue Cross Blue Shield Association’s recommendations to promote cost transparency.

Medicare Part D – Despite the success of the Medicare prescription drug program in enabling seniors to access the medicines they need, the high cost of prescription drugs continues to place a financial burden on too many Medicare beneficiaries. Establishing a maximum out-of-pocket spending limit will provide protection from high prices and ensure drug manufacturers are more accountable for costs. Any reforms to Medicare Part D should prevent disruption to the program, strengthen financial protections for beneficiaries while not increasing premiums, and hold manufacturers accountable for drug prices.

Learn more about the Blue Cross and Blue Shield Association and Medicare.

Health Insurance Tax – A critical step that Congress can take to lower premiums is to act as soon as possible to provide relief from the health insurance tax (HIT). If HIT relief is not enacted this year, actuarial firm Oliver Wyman projects that annual family premiums will rise by $400-$500 both in commercial plans and in Medicare Advantage.

See the Blue Cross Blue Shield Association recommendations to provide HIT relief.

Prescription Drug Costs – We are committed to addressing market challenges that lead to high drug prices and encourage Congress to pass the CREATES Act to discourage abuses in the prescription drug market and improve access to generic drugs, which the CBO estimates will save taxpayers $3.9 billion. Congress should also prohibit anti-competitive pay-for-delay agreements that hinder consumer access to generics and biosimilars.

Learn more about how the Blue Cross Blue Shield Association is addressing prescription drug costs.

Lower premiums and expand coverage by fixing the ACA – With nearly 300 million Americans now covered, we need to build on what’s good in our current healthcare system to achieve universal coverage and reduce costs. In a recent op-ed for CNN.com, Blue Cross Blue Shield Association President and CEO Scott Serota speaks to how we can close the coverage gap for the 10 percent who still need it without disrupting coverage for the other 90 percent.

Read the op-ed.