California congressman proposes testing automatic enrollment in ACA plans

U.S. Rep. Ami Bera, MD, D-California, has introduced legislation that would allow states to test a version of automatic enrollment in health insurance plans while giving customers a way to opt out of coverage.

In states which choose to utilize federal grants for the pilot program created by Bera’s bill, called the “Pathway to Universal Coverage Act,” those who don’t want coverage would have to actively opt out of plans. They would have 60 days to do so under the legislation, which Bera said would ensure consumer choice is protected while also making it more likely customers sign up—particularly those who don’t realize they qualify for ACA subsidies which cover most or all of their monthly premiums.

“As a doctor, I know that health care is extremely personal,” Bera said in a press release. “Too many hardworking families have been left out or left behind by premiums and deductibles they can’t afford. Americans deserve a plan that protects their current health care coverage, expands enrollment, and reduces costs for everyone.”

Automatic enrollment in some basic level of insurance coverage has been floated by both liberal groups and Republican senators. Sens. Susan Collins, R-Maine, and Bill Cassidy, MD, R-Louisiana, proposed it for their “Patient Freedom Act” in 2017 as the coverage incentive in place of the ACA’s individual mandate. Like Bera’s plan, people would’ve been allowed to opt out of the coverage with no penalty.

Conservative groups came out firmly against the plan, and the Cassidy-Collins bill never went anywhere amid failed efforts by Republicans to repeal the ACA last year. Collins ended up being one of three Republican “no” votes against ACA repeal in the Senate while Cassidy pushed a more conservative repeal effort with Sen. Lindsey Graham, R-South Carolina, which centered on block granting much of the ACA’s funding without providing a replacement for the mandate to encourage buying coverage.

Along with the automatic enrollment bill, Bera also introduced legislation to move the ACA’s open enrollment period to align with tax season, ending on April 15. He argued ending enrollment in December has led to people avoiding the ACA exchanges because of the busy holiday season and financial stress at the end of the year.

""
John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”