AHIP is focused on redefining Medicaid and promoting competition in the 2023 market.
A trade group representing health insurance companies held a ‘state of the industry’ roundtable on January 9th. AHIP President and CEO Matt Eyles and other executives set out legislative priorities at the federal and state levels for 2023.
Here are seven key takeaways from the discussion.
- Many Medicaid beneficiaries are unaware of the rededication process, which is scheduled to begin on April 1, Ailes said. He urged states to communicate with policyholders about administrative requirements to facilitate a smooth transition to other forms of insurance for those who are disqualified.
“Our industry is committed to working with all stakeholders to ensure that as many Americans as possible are insured,” Eyles said.
- AHIP will push policies to promote competition in the market, Mr Eyles said on a conference call.
“Towards 2023, we will continue to prioritize reforms that remove some incentives and opportunities. [private equity] Companies and others exploit patients for profit.”
Janet Thornton, AHIP’s executive vice president of policy and strategy, said competition has led to more choices for ACA exchange plans in 2023 and increased enrollment.
“By 2023, the regulatory environment will continue to stabilize, allowing the millions of Americans who truly depend on health insurance to continue using this market,” Thornton said. rice field.
- The plan for AHIP members is to continue to expand the mental health network and add home and virtual behavioral health resources, Eyles said.
“We are committed to improving affordability, access, quality and outcomes for everyone seeking mental health support.
- State legislatures are likely to focus on preapproval reform in 2023, said Miranda Motter, senior vice president of state affairs and politics.
“The state requires preapproval and other critical access control tools that employers know they are currently using to ensure that patients receive safe, effective, and affordable care. There is pressure to limit the
At the state level, health insurance providers are communicating the value of preapproval to legislators and sharing ongoing reforms, Motter said.
- Industry groups are also committed to improving health equity, Eyles said. The association finalized new demographic data collection standards last year.
- Another priority for the trade association in 2023 is to address prescription drug costs.
Ailes said drug companies are driving up the cost of drugs by blocking generic biosimilars or pushing brand-name drugs onto patients.
“Federal and state policymakers can fix this system by holding big pharmaceutical companies accountable,” Eyles said.
- The state legislature will also consider regulation of prescription drug prices in 2023, Motter said.
Pharmaceutical companies are trying to keep copay coupons at the state level. Motter said these coupons could manipulate prices in the pharmaceutical market.
“These coupons are illegal kickbacks in public programs like Medicaid and Medicare. That’s why big pharmaceutical companies are turning to other markets and encouraging patients to use coupons to buy more expensive branded drugs.” We are doing it,” said Motter.