The Other Health Insurance Gap – The Tribune Papers- Breaking News & Top Local Stories

By Mark Zimmerman,
Senior Vice President of External Affairs, NC REALTORS®-

The political discussion surrounding health care in Raleigh this year has been dominated by the issue of Medicaid expansion.

This is a priority of the Governor, who wants to provide coverage to those who earn too much to qualify for Medicaid, but not enough to qualify for Affordable Care Act (ACA) insurance subsidies. The General Assembly doesn’t yet agree.

Lost in this debate is another group of North Carolinians who are uninsured. These middle-class residents earn too much to qualify for subsidies, but not enough to pay for its marketplace insurance.

This has created two distinct gaps in insurance coverage in North Carolina, and Medicaid expansion would only cover one of them. How do we help provide insurance to the other group? The answer is by giving them access to lower cost group insurance through what is known as Association Health Plans (AHPs). This is an idea on which the General Assembly- with broad, bipartisan consensus – does agree.

Right now, only large corporations can offer group health coverage. Independent contractors, small business owners and their employees must buy an individual plan. Those plans are much more expensive than group plans and lack the power of negotiating rates and coverage

Senate Bill 86 will allow for statewide trade associations, like the Chamber of Commerce or NC REALTORS, to offer their members group plans. These plans will be nearly identical to the large group employer-based plans that have long covered the majority of Americans.

Not unexpectedly, ideas this innovative attract some criticism. Fortunately, the facts support AHPs.

Some say AHPs would dilute the pool of customers for the current ACA, raising the price of those plans. The non-partisan Congressional Budget Office and Joint Committee on Taxation (CBO/JCT) studied the impact AHPs would have on the ACA. They concluded any minimal cost increases will be covered by Federal subsidies and AHPs will not result in a “noticeable decline in insurance coverage [by the ACA].”

Others feel the plans won’t provide quality coverage. The CBO/JCT looked into that, as well, and asserts AHPs will “still offer coverage that that is similar to comprehensive employment-based coverage.

We recognize that a comprehensive approach would be ideal, but it seems prudent to close one of the coverage gaps with a solution that already has broad support.

The need for AHPs is very real. When we surveyed our 45,000 REALTOR® members, over 6,000 of them told us they no longer have health insurance because it is too expensive. Many more have had to reduce coverage to the bare minimum. These people are living on the edge, one accident or medical issue away from serious illness or bankruptcy. Even many of those who have health insurance must make impossible choices every day, foregoing other basic necessities in order to afford it.

It doesn’t have to be that way. By saying yes to Association Health Plans, we can improve people’s health and well-being. Democrats and Republicans in the General Assembly agree on this important bill. Now it’s in the Governor’s hands to bring substantial life-saving benefits to thousands of North Carolinians.

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