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Greater Access to Care a Central Focus of Relief Legislation

July 06, 2021  |  Article

 

Yogin Shroff, Senior Partner and Chief Operating Officer

How has the COVID-19 pandemic impacted access to healthcare coverage, and where does ARPA provide relief?



Access to care affects countless individuals – both insured and uninsured. Not only is low access to care a significant contributor to avoidable ED utilization, but it is also a source of emergency medical conditions that could be prevented with proper primary care services. COVID-19 has only exacerbated the situation for many.

COVID-19 AND ACCESS TO CARE

Some reports suggest that upward of 12 million individuals lost Employer-Sponsored Insurance (ESI) during the pandemic. Because millions of these plans included spouses and children, the net effect on the population was even greater.1

Next, the pandemic created new limitations on primary care services, not only via stay-at-home orders, but also via the cash flow challenges it represented for many primary care providers. Those practices that were unable to navigate their balance sheet difficulties were forced to close. The impact was so significant that primary care providers were among the first to receive a disbursement from the Congressional emergency fund – although in most cases it only provided an additional week of life support for fledgling practices.2 Regrettably, these closures disproportionately affected those in rural neighborhoods and communities of color.

Finally, little is known about how the COVID-19 pandemic will impact the future of healthcare finance. Many expect that individual consumers will bear the burden of higher overall healthcare costs. Unless strong policy legislation is implemented, this strain will further reduce access to affordable care for many.

HOW DOES THE AMERICAN RESCUE PLAN ACT IMPACT HEALTHCARE COVERAGE?

The American Rescue Plan Act (ARPA) strives to serve three broad areas of healthcare coverage: Access, Affordability, and Expansion.

ACCESS TO CARE

In the name of supporting mental health during a time of crisis, ARPA has infused $3.5 billion across Substance Abuse Prevention and Treatment block grants and Community Mental Health block grants.3 ARPA is also pushing considerable funds toward behavioral health needs for children and providing grants for providers to promote awareness around mental health and behavioral health.4

In addition, this relief package consists of $7.6 billion in investment in community health centers to continue serving rural and low-income populations.4

AFFORDABILITY

Nearly 15 million Americans lack access to affordable health insurance. Via its tax credit system, ARPA will reduce out-of-pocket costs related to premiums for this underserved population.5

Furthermore, ARPA will mitigate some of the rippling economic effects of unemployment and reduction in hours. Through September 30, 2021, the legislation provides a COBRA continuation coverage subsidy for individuals and families who experienced involuntary unemployment resulting in the loss of ESI coverage.6

MEDICAID EXPANSION

ARPA prescribes an increase of 10 percentage points to the federal medical assistance program (FMAP).7 This will afford states higher spending capability on Home and Community-Based Services (HCBS), expanding care among individuals in rural and low-income communities.

This provision not only allows greater access to adequate healthcare coverage for the underserved, but it also promotes greater health and racial equity across the country.

REFERENCES

1 Economic Policy (2020) 12 million people have likely lost employer-sponsored health insurance since February. Retrieved from https://www.epi.org/press/12-million-people-have-likely-lost-employer-sponsored-health-insurance-since-february-policymakers-should-work-to-delink-jobs-and-access-to-insurance-coverage-by-expanding-public-options/

2 Slavitt A, Mostashari, F (2020, May 28) Covid-19 is battering independent physician practices. They need help now. Retrieved from https://www.statnews.com/2020/05/28/covid-19-battering-independent-physician-practices/

3 Melley, K (2021, February 26) House American Rescue Plan Act Would Extend Affordable Healthcare Coverage to Millions Struggling Amid Pandemic. Retrieved from https://www.communitycatalyst.org/news/press-releases/house-american-rescue-plan-act

4 National Association of Counties (2021, April 12) American Rescue Plan Act Funding Breakdown. Retrieved from https://www.naco.org/resources/featured/american-rescue-plan-act-funding-breakdown

5 HHS Press (2021, March 12) Fact Sheet: The American Rescue Plan: Reduces Health Care Costs, Expands Access to Insurance Coverage and Address Health Care Disparities. Retrieved from https://www.hhs.gov/about/news/2021/03/12/fact-sheet-american-rescue-plan-reduces-health-care-costs-expands-access-insurance-coverage.html

6 United Healthcare (2021, April 9) COBRA and American Rescue Plan Act and Premium Tax Credits. Retrieved from https://www.uhc.com/broker-consultant/news-strategies/resources/cobra-and-american-rescue-plan-act-and-premium-tax-credits

7 Centers for Medicaid and Medicaid Services (2021, May 13) CMS Issues Guidance on American Rescue Plan Funding for Medicaid Home and Community Based Services https://www.cms.gov/newsroom/press-releases/cms-issues-guidance-american-rescue-plan-funding-medicaid-home-and-community-based-services

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