Washington, D.C. — A new column from the Center for American Progress estimates that the rumored Senate Affordable Care Act (ACA) repeal bill—which a group of senators are currently writing in secret—would erode or eliminate financial protections for about 27 million workers and their dependents, including individuals on large-employer plans. Nearly 27 million people with employer-based coverage would face lifetime limits on coverage, and 20 million would face lifetime limits on coverage.
The protections would be undermined by the reported inclusion of waivers that would let states drop required coverage for essential health benefits, such as maternity care, hospitalization and drug addiction treatment. In turn, insurers would be allowed to once again reinstate lifetime and annual caps on these services—a fact confirmed by the Congressional Budget Office analysis of the House bill.
“As long as the Senate bill includes essential health benefit waivers, families will be denied sometimes lifesaving care because they can’t afford it. The Republican bill’s waivers of essential health benefits threaten coverage not just for the individual market but also for the roughly 134 million Americans covered through large employers,” said Topher Spiro, Vice President of health policy at American Progress.
The Center for American Progress combined the results of a survey by Willis Towers Watson—which found that among large employers, 20 percent said they would impose annual limits and 15 percent said they would impose lifetime limits if ACA protections were repealed—and census data to estimate the number of people with employer-based coverage who would be affected in each state.
“A cap on benefits could be catastrophic. Nearly 27 million individuals with employer coverage would have less health insurance protection due to the waivers, potentially leaving their families one emergency away from financial crisis,” said Emily Gee, health economist at American Progress.
Prior to the ACA, 59 percent of enrollees on employer plans had lifetime limits, leaving many with serious health conditions financially struggling or even bankrupt when insurance companies ceased paying for benefits.
Under the Senate repeal bill, a large employer could choose the waiver state that provided it with the most flexibility on benefits. For example, Walmart, which is headquartered in Arkansas but has operations in all 50 states, could choose to apply Utah’s standard—or lack thereof—to coverage for all its employees. In this indirect way, Walmart could impose annual and lifetime limits on any benefit for all its employees nationwide.
Click here to read “The Emerging Senate Repeal Bill Eviscerates Protections for Millions in Employer Plans Nationwide” by Topher Spiro and Emily Gee.
For more information or to speak to an expert, contact Devon Kearns at firstname.lastname@example.org or 202.478.5328.