Over 20 National Patient Advocacy Groups Respond to CMS Request for Information on ACA Regulatory Burdens; Call on Agency to Fix Rule Impeding Access to Life-Saving Charitable Patient Assistance

WASHINGTON, D.C. (July 10, 2017) – The Marketplace Access Project (MAP), a group of 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 responded to a Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) regarding regulatory burdens of the Affordable Care Act (ACA), urging the agency to modify a federal rule that allows insurance companies to deny coverage to patients who receive assistance from charities under the ACA.

On June 12, 2017, CMS issued an RFI seeking public comment on ACA regulatory burdens and steps the agency can take to create a more patient-centered health care system that advances affordability, accessibility, quality, innovation, and empowerment. The RFI comes on the heels of a CMS rulemaking on third-party insurance payments for the new Exchange plans offered under the ACA. In direct contradiction to the standard currently followed by Medicare, CMS failed to include non-profit charities on the list of acceptable premium and cost-sharing arrangements for patients covered by qualified health plans. As a result, insurers across 41 states are citing this rule to deny coverage to patients simply because they receive assistance from charities.

“Most patients who depend on assistance have rare and chronic illnesses which require complex, often expensive, life-sustaining treatments that they do not have the option to forgo,” MAP wrote in its comments. “[The CMS rule on third-party payers] has provided an impetus for providers to purge their plans of sick patients.”

Over the past year, lawmakers have been pursuing legislative and administrative solutions to end CMS’ harmful rule. In May 2017, 184 members of Congress – 40 percent of the U.S. House of Representatives – sent a letter to Department of Health and Human Services (HHS) Secretary Tom Price urging an administrative fix for the CMS rule. In 2016, Rep. Kevin Cramer (R-ND) introduced federal legislation, which he is expected to reintroduce in the coming months, that would modify CMS’ policy to allow non-profit charities to continue to provide critical assistance to patients under CMS’ existing third-party policy.

“MAP and our members welcome the opportunity presented by this RFI to once again reaffirm our organizational missions to remove the increasing premium, copayment and co-insurance barriers to affordable care for patients with rare and chronic illnesses and people with disabilities,” MAP added in its comments. “Authorizing these entities to continue to provide third-party premium and cost-sharing assistance would help ensure access to life-saving care for some of our nation’s most vulnerable patient populations, all while saving taxpayer dollars.”

To read MAP’s full comments, 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 (@marketplaceaccess).