Carper, Kaine Introduce Bill to Improve the Health Care Marketplace and Lower Premiums

WASHINGTON, D.C. – On Wednesday, U.S. Senator Tom Carper (D-Del.), a member of the Senate Finance Committee, introduced the Individual Health Insurance Marketplace Improvement Act to help stabilize the individual health care marketplace and lower premiums. 

The Act would provide certainty in the marketplace by creating a permanent reinsurance program for the individual health insurance market, similar to the successful programs used to lower premiums and spur competition in the Medicare Part D program.

This reinsurance program would provide funding to offset larger than expected insurance claims for health insurance companies participating in the state and federal insurance marketplaces, encouraging them to offer more plans in a greater number of markets, improving competition and driving down costs for patients and families. Additionally, the bill would provide $500 million a year from 2018 to 2020 to help states improve outreach and enrollment for the health insurance marketplaces, drawing in new members and educating the public about the need to be insured. This outreach funding prioritizes counties where there are limited insurers left in the marketplace. 

“The Affordable Care Act has made incredible strides toward ensuring access to high-quality health care for every American, but the law isn’t perfect and Congress must work together across party lines to make it better,” said Carper. “That is why I worked with several of my Senate colleagues to introduce legislation that would inject more stability into the individual insurance market, and do so by replicating the stabilization efforts that have worked so well in the bipartisan Medicare Part D program. By providing insurers with the certainty they need to participate in the individual insurance markets, this bill will increase competition among insurers and lower premiums for consumers.”

“The only way to get health care right in this country is for both parties to work together on real solutions for all Americans,” Kaine said. “After months of uncertainty, our bill would work to stabilize the individual market through a reinsurance program modeled after the bipartisan Medicare Part D plan. I have long said I was willing to work on ways to improve the Affordable Care Act, and if my colleagues are serious about looking for a way to fulfill President Trump’s promises that no one will pay more and no one will lose coverage, especially those with preexisting conditions, then this is a great place to start. This is just one way to improve affordability and choices for consumers and I look forward to working on additional solutions.”

The Individual Health Insurance Marketplace Improvement Act would:

·         Lower premiums, which would then decrease the cost of Advance Premium tax credits,

·         Increase competition among insurers,

·         Provide funding to states to improve outreach and enrollment in the health insurance marketplaces,

·         And provide additional marketplace stability for insurers, providers, and patients.

The reinsurance program would increase stability in the individual health insurance marketplaces by providing federal funding to cover 80 percent of insurance claims between $50,000 and $500,000 from 2018-2020. Starting in 2021, federal funding would cover 80 percent of insurance claims between $100,000 and $500,000.

Carper introduced the bill with Senators Tim Kaine (D-Va.), a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Bill Nelson (D-Fla.), Jeanne Shaheen (D-N.H.), Maggie Hassan (D-N.H.), and Ben Cardin (D-Md.).

View full text of the Individual Health Insurance Marketplace Improvement Act here.