OP-ED CONTRIBUTOR

Charity Assistance for Nation’s Most Vulnerable Patients Must Be Protected

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.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Briefings

Health Brief: GOP Senators Ask CBO to Fast-Track ACA Overhaul Review

Senate Republican leaders have asked the Congressional Budget Office to fast-track consideration of a plan from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to overhaul the Affordable Care Act. The CBO is reportedly in the process of analyzing the cost and coverage impact of the plan, as Republicans face pressure to make one last attempt at undoing the ACA before GOP senators’ ability to pass legislation with a simple majority expires on Sept. 30.

Health Brief: Week in Review & What’s Ahead

HELP Committee Chairman Lamar Alexander (R-Tenn.) hopes to reach a deal with Democrats on a plan to shore up the ACA exchanges early this week. A final agreement, if reached, is likely to extend key insurer payments, known as cost-sharing reductions, and include reforms to make it easier for states to establish reinsurance programs. Some Republicans are also pushing to give states more flexibility over required benefits in Obamacare plans, a proposal that is controversial with Democrats.

Health Brief: Some Moderate House Democrats Seek ACA Stabilization

While progressives this week rallied behind Sen. Bernie Sanders’ (I-Vt.) single-payer health care bill, a group of moderate House Democrats in the New Democrat Coalition aligned themselves with the Senate Health, Education, Labor and Pensions Committee’s bipartisan push to stabilize the Affordable Care Act exchanges, which Committee Chairman Lamar Alexander (R-Tenn.) aims to reach a final deal on by early next week.

Health Brief: Deal Reached to Extend CHIP Funding

Senate Finance Committee leaders reached a deal on a five-year reauthorization of the Children’s Health Insurance Program, in a win for children’s health advocates who are seeking longer-term funding certainty for the program, which will expire at the end of the month without congressional action. The deal also gradually phases out the enhanced federal share of funding for state CHIP programs, which was increased under the Affordable Care Act by 23 percentage points.

Health Brief: Some Navigators Shut Down Ahead of ACA Enrollment Period

Several navigator organizations, including one that received the largest federal grant for Obamacare enrollment activities in 2016, are suspending operations ahead of the 2018 open enrollment season because they haven’t received contracts for funding from the Department of Health and Human Services, which could cause enrollment to plummet. The Trump administration announced plans last month to cut funding for navigator groups by about 40 percent, but health officials haven’t said whether the grants would end altogether.

Health Brief: Teva Names New CEO

H. Lundbeck A/S’s Kaare Schultz was named as Teva Pharmaceutical Industries Ltd.’s new chief executive officer, ending a seven-month search by the world’s largest generic drug maker to find a new leader. Schultz could face pressure to split the company into two businesses, one focusing on patented specialty drugs and the other on cheap copycat medicines

Load More