Letter Sent by Over 20 National Patient Advocacy Groups Calls on E&C Committee Members to Cosponsor Access to Marketplace Insurance Act; Bill Would Protect Quarter of a Million Americans Who Depend on Charity Assistance for Access to Critical Healthcare

 WASHINGTON, D.C. (November 6, 2017) – The Marketplace Access Project (MAP), a group of over 20 leading national patient advocacy organizations dedicated to protecting non-profit insurance premium and cost-sharing assistance for individuals suffering from chronic and life-threatening illnesses, today sent a letter to all 55 members of the U.S. House of Representatives Energy and Commerce Committee urging their support for the Access to Marketplace Insurance Act (H.R. 3976). This critical legislation, which was reintroduced by Rep. Kevin Cramer (R-ND) last month and received 147 bipartisan cosponsors last Congress, would modify a rule by the U.S. Centers for Medicare and Medicaid Services (CMS) that allowed health insurers to refuse to cover patients enrolled in qualified health plans (QHPs) if they receive premium or cost-sharing assistance from non-profit charities, including churches and civic groups.

“Individuals living with chronic and life-threatening illnesses, such as cancer, HIV/AIDS, and autoimmune diseases, often face prohibitive costs to simply maintain their health insurance,” MAP wrote. “To bridge this gap, non-profit premium and cost-sharing assistance charities temporarily step in to help patients cover the costs of the care they need to effectively manage their conditions and live healthy, productive lives. Not only do these charities provide a vital lifeline for those most in-need, but they do so at no added cost to the public.”

On March 19, 2014, CMS issued federal guidance on third-party insurance payments for the new Exchange plans offered under the Affordable Care Act (ACA). In direct contradiction to the standard currently followed by Medicare, CMS failed to include non-profit charities on the list of acceptable premium arrangements for patients covered by QHPs. Insurers across 41 states are now citing this CMS guidance to deny coverage to patients by rejecting the premium and cost-sharing assistance they were previously receiving from third-party charities.

To address this loophole, Rep. Cramer originally introduced the Access to Marketplace Insurance Act in the House of Representatives in November 2016. The legislation (previously known as H.R. 3742) earned the support of 147 bipartisan cosponsors during the final months of the 114th Congress. The Access to Marketplace Insurance Act would modify the CMS guidance by allowing those with chronic and rare diseases to continue to access their healthcare with charitable aid.

In their letter, MAP put to rest false claims being made about the legislation by some insurance industry stakeholders, such as that patients who receive charity support can easily obtain public assistance through Medicare and Medicaid, and urged House Energy and Commerce Committee members not to prioritize insurance industry cost concerns over patient lives. “When an insurer prohibits charity assistance, a patient can either attempt to qualify for Medicaid by divesting themselves of assets or undergo the arduous and lengthy process of obtaining Medicare benefits via disability. Patients unlucky enough to be born with chronic and costly conditions shouldn’t have to radically change their lives to access the care that their physicians prescribe – especially when the care would be unnecessarily supported by resource-strapped public programs, instead of charity donations.”

The group added, “At a time when lawmakers are working to reduce government health-care spending, it’s hard to make sense of a federal policy that prevents charities from picking up some of the slack for Americans with particularly costly conditions.”

To read the full letter, click here.

For more information on the Marketplace Access Project, visit www.marketplaceaccess.org.  

 About MAP

The Marketplace Access Project (MAP) is a patient advocacy movement dedicated to protecting non-profit insurance premium and cost-sharing assistance for individuals suffering from chronic and life-threatening illnesses. For more information, visit www.marketplaceaccess.org, or follow MAP on Twitter (@AccessProjectUS) and Facebook (www.facebook.com/marketplaceaccess).