By Dana A. Kuhn
July 13, 2017 at 5:00 am ET
For more than 100 years, charitable organizations — and the American capacity for charitable giving — have formed a critical part of this country’s backbone. Charities help shift onerous social and healthcare costs away from taxpayers while improving, and often saving, lives — a service that is even more critical now that Congress is proposing deep cuts to government-funded health care programs.
According to Giving USA, in 2015 charitable organizations saved the federal government $358 billion – $2.9 billion of which went to human service organizations. Nowhere is the power of charitable giving more apparent than in healthcare.
Health insurers are increasingly raising premiums (into the double digits) and patient out-of-pocket costs (by at least $1,000) placing the insurance coverage necessary to manage chronic and life-threatening conditions — including cancer, HIV/AIDS, hemophilia, and others — out of reach for many Americans.
When medication becomes too expensive, patients often forego necessary treatments, leading to deteriorating health outcomes and even death. Many of these patients become too ill to regularly attend work, resulting in unemployment and loss of insurance, while others resort to government programs or visit hospitals for primary care, which drives up uncompensated care costs ultimately paid for by American taxpayers.
Thankfully, there are charitable organizations across the country that exist precisely to create a temporary safety net for these patients so that they don’t have to bear the financial, legal, emotional and potential mortality burdens associated with their conditions alone. Non-profit patient assistance programs help as many as three-quarters of a million Americans in dire need cover the costs of their life-saving and life-sustaining treatments and services — all without costing the government a dime.
Yet a misguided federal rule is jeopardizing this life-saving assistance. Since 2014, a federal policy issued by the Centers for Medicare and Medicaid Services has allowed insurers to deny health coverage to many of the nation’s sickest patients simply because they receive assistance from charities.
Currently, health insurers in 41 states are citing this policy to refuse coverage to patients who benefit from premium and copay charity assistance, unnecessarily putting countless American lives at risk.
Without charity assistance programs, patients with expensive conditions would be forced to try to enroll in public healthcare programs like Medicaid, which will likely undergo deep cuts under new national healthcare legislation. If our nation’s most vulnerable patients cannot access the care that they need help from charities, and public health care funds become increasingly scarce, they will be left with nowhere to turn.
Fortunately, new opportunities are on the horizon for lawmakers to step in and end this harmful rule once and for all. In May, 184 bipartisan members of Congress — 40 percent of the U.S. House of Representatives — sent a letter to Department of Health and Human Services Secretary Tom Price urging an administrative fix for the CMS rule. Short of an administrative fix, Rep. Kevin Cramer (R-N.D.) is expected to introduce new legislation in the coming months to modify CMS’ policy.
When I founded Patient Services Inc., I thought it would be a temporary solution to help families get the healthcare they needed until the government and industry found a sustainable solution to rising health costs. Unfortunately, that was nearly 30 years ago — costs continue to go up, all while the lives of patients hang in the balance.
In the absence of a long-term solution to address rising healthcare costs, and potential cuts to Medicaid looming, policymakers must ensure that non-profit charities can continue to help as many patients as possible.
Dana A. Kuhn is the founder and president of Patient Services Inc., a nonprofit patient assistance organization based in Midlothian, Va.
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