An Illinois congressman has introduced an Obamacare opt-out plan. | Courtesy of Shutterstock
+ Regulatory
Kim Sunderland | Aug 5, 2016

Illinois congressman proposes Obamacare opt-out plan

Rep. Randy Hultgren (R-IL) has introduced legislation he believes will help Americans parachute off an over-regulated health insurance market that is characterized by rising premiums and limited plan options.

More specifically, the State Health Care Options Act, or H.R. 3352, is a waiver plan that would allow states to opt out of certain provisions of the Affordable Care Act (ACA) that pertain to qualified health plans and insurance exchanges.

Additionally, the bill would give states an opportunity to chart a course away from a law that has not lived up to its promises, Hultgren recently told Patient Daily News.

“The ACA’s supporters promised that the law would get more Americans insured at a lower cost,” he said. “Nearly six years later, the Congressional Budget Office revealed that the opposite is true -- enrollee projections were too high, and cost projections were too low.”

The cost of the law and its unintended consequences, Hultgren said, are having a serious impact on American families.

In fact, earlier this week, the leading insurer on the Illinois Obamacare exchange, Blue Cross Blue Shield, proposed increases for 2017 ranging from 23 to 45 percent for individual health care plans, while another insurer, Coventry Health Care of Illinois, proposed rate increases of up to 21 percent.

In a statement, Health Care Service Corp. (HCSC), which operates Blue Cross Blue Shield of Illinois, said that although no final decision has been made, the proposed rates are in line with those in many markets across the country. It added that, while some carriers have chosen to exit the market, it is working to continue providing health insurance options for consumers.

“However, that must be done in a sustainable way,” according to the HCSC statement. “Premium rates must cover the anticipated health care needs of our members, and consumer protections exist in the way of rebates if a certain percent of premiums do not go directly to covering medical services and quality programs.”

Proposed increases have been expected because the health care law has been a source of financial strain for many companies.

Hultgren said he’s been working with people across his district who have come to him with their concerns and suggestions regarding health care. Everyone has agreed, he said, that the ACA is preventing the state’s health insurance market from offering consumers real options, real access and manageable costs.

“It’s clear to me that the best, most innovative solutions to the existing problems in our nation’s health care system will come from the people on the ground who come up against these challenges every day,” Hultgren said.

Hultgren’s bill hopes to streamline the process for ACA waivers for state innovation, allowing states to opt out of certain provisions of the law without relying exclusively on approval from the U.S. Health and Human Service Department; allowing residents of waiver states to purchase health plans outside an exchange -- whether through an agent or broker, on a private exchange, or directly from an insurer; preventing residents of waiver states from being locked into a health plan for a full year by releasing states from the annual open enrollment period; and continuing to provide federal health insurance subsidies for individuals living at or below 300 percent of the federal poverty level.

“A one-size-fits-all approach has failed over and over again,” he said. “Instead, my alternative will give states relief from the ACA’s mandates and costs so they can target solutions for their residents.”

Hultgren, who represents the 14th District of Illinois, is a strong supporter of House efforts to repeal and replace the ACA and strip the law of some of its most expensive provisions -- including bills that would repeal the health insurance tax, the medical device tax and the excise tax.

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