Letter to the Hon. Joseph R. Biden, President of the United States - King Pushes to Lower Deductibles & Out-of-Pocket Expenses, Easing Costly Burdens of Healthcare

Letter

Dear Mr. President,

As your administration works with Congress to develop a policy framework to advance the Build Back Better agenda, we write to urge you to ensure that policies to improve the affordability of health care coverage are central to those efforts. We applaud your proposal in the American Families Plan to permanently extend the critical but temporary improvements in health insurance premium affordability enacted in the American Rescue Plan Act. These premium tax credit enhancements will substantially reduce net premiums paid by American families for Health Insurance Marketplace coverage and begin to reduce the number of people who are uninsured. To truly deliver accessible and affordable care to Americans across this country, Congress will need to make premium tax credit improvements permanent, as you have proposed, while also making an investment to reduce deductibles and out-of-pocket expenses for individuals and families.

Too many American families face significant deductible and out-of-pocket costs that threaten their access to the care they need. The average deductible for silver-level Marketplace plans in 2021 is nearly $5,000 for individuals, and while low-income people can access plans with reduced cost-sharing, that help is not always sufficient. For example, a person with income of $26,000 a year would still have an average deductible of more than $3,000, a staggering 13 percent of their income. Significant deductibles and cost-sharing expenses are also a barrier to care in employer-based coverage. High deductibles and out-of-pocket costs can discourage people from even enrolling in health coverage, no matter how much financial assistance they can get with premiums. To make historic progress toward covering the uninsured, and to ensure that having coverage truly delivers affordable access to health care and improved financial security, additional federal assistance to reduce cost-sharing expenses is critical.

Your administration has the opportunity to work with Congress to strengthen Medicaid and the Marketplaces, which have provided a crucial safety net during the COVID-19 health and economic crisis. Your administration's decision to open an emergency special enrollment period at HealthCare.gov allowed more than one million people to enroll in coverage by early May, with many of them accessing plans with $0 net premiums because of the premium tax credit enhancements under American Rescue Plan. In order to ensure lasting affordability of premiums and long-term reductions in the number of uninsured in this country, we will need to provide a long-term investment in premium assistance and close the Medicaid coverage gap for low-income individuals in states that have not expanded Medicaid under the Affordable Care Act.

Providing affordable, comprehensive coverage to the nation's uninsured is a vital component of building a health care system that is equipped to ensure equity in health outcomes regardless of race or ethnicity. People of color are currently disproportionately represented among the uninsured. While increasing health coverage will not solve every health care inequity, having coverage has been shown to increase access to health care services, including preventive services and treatment for chronic disease, which can save lives.

In the weeks and months ahead, we look forward to working with you on these priorities so that we can ensure that Americans have access to affordable coverage now and in the years to come. Thank you for your attention to these critical issues.