R.I. health insurance commissioner joins other states in supporting ACA recommendations

MARIE L. GANIM, Rhode Island's health insurance commissioner, signed a letter Wednesday, pledging to work with President-elect Joe Biden on health policy recommendations. / PBN FILE PHOTO/ RUPERT WHITELY
MARIE L. GANIM, Rhode Island's health insurance commissioner, signed a letter Wednesday pledging to work with President-elect Joe Biden on health policy recommendations. / PBN FILE PHOTO/ RUPERT WHITELY

PROVIDENCE – Marie Ganim, Rhode Island’s outgoing health insurance commissioner, signed a letter on Wednesday pledging to work with President-elect Joe Biden on health policy recommendations.

Ganim, who will retire from her post in early January, was one of 11 state insurance commissioners to sign the letter to the incoming administration, which detailed six immediate policy recommendations.

She told PBN that after her retirement, she expects the R.I. Office of the Health Insurance Commissioner to continue to work closely with Gov. Gina M. Raimondo, Rhode Island’s congressional delegation and the Biden administration to “pursue mutual goals of expanded and equitable access to affordable and comprehensive health insurance for Rhode Islanders.”

Raimondo has nominated former Medicaid Director Patrick M. Tigue to replace Ganim.

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Ganim told PBN that while Biden has a comprehensive health care agenda that includes expanding upon the Affordable Care Act, state insurance regulators have seen a number of federal policy changes in recent years that have posed challenges to consumer access in both affordability and in comprehensive coverage.

“State insurance regulators are in a relatively unique position to experience and understand the interplay between federal and state health care policies,” said Ganim. “Most commissioners are acutely familiar with the challenges that consumers face as they attempt to secure health insurance for themselves and families.”

Ganim said that under a Biden administration, she expects to see the number of uninsured and underinsured Americans to decrease dramatically.

A spokesperson for the Biden transition team was not immediately available to confirm that the president-elect received the letter.

Some of the immediate plans the commissioners outlined include ensuring immediate access to the federal marketplace on Healthcare.gov through a special enrollment period, providing immediate relief from the ACA subsidy clawbacks created by COVID-19 uncertainty, partnering with states to focus on programs that address the needs of historically marginalized communities and to provide clarity on COVID-19 testing coverage requirements.

Ganim said the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act requires federally approved COVID-19 tests for diagnostic purposes if ordered by an appropriate clinician and to be covered by all forms of insurance.

“There should be no out-of-pocket requirements if the test meets the diagnostic, clinician-ordered criteria,” said Ganim. She said the federal requirement will last through the duration of the federal declaration of emergency.

The commissioners outlined other urgent policies, included addressing problematic elements of the recently proposed Notice of Benefit and Payment Parameters for Plan Year 2022 and allowing flexibility for states aiming to pursue progressive policy aims by empowering them to apply for ACA innovation waivers beyond reinsurance.

Ganim said Raimondo has fully embraced the ACA in Rhode Island and it has proven to be successful.

“We have one of the lowest uninsured rates in the nation, and most Rhode Islanders enjoy comprehensive coverage,” said Ganim. “With federal assistance, more could be done to make this insurance more affordable and equitable, as is reflected in this joint letter.”

State commissioners from California, Colorado, Delaware, Hawaii, Michigan, Minnesota, Oregon, Pennsylvania, Washington and Wisconsin also signed the letter.

“We share your vision that no American should have to go without health care coverage or have coverage that fails them when they need it most,” the commissioners wrote to Biden.

The commissioners identified longer-term policy priorities at the end of their letter. These included:

  • Reverse policies, such as the weakening of non-discrimination protections and the public charge rule, that undermine the ACA and deny health care coverage to many people.
  • Encourage both people and small businesses to enroll in ACA programs, and stop encouraging enrollment in insurance plans that do not provide the ACA’s most critical consumer protections.
  • Improve income counting rules to allow consumers greater flexibility.
  • Extend premium tax credits to Deferred Action for Childhood Arrivals (DACA) recipients so that legally present non-citizens have access to health care coverage.
  • Modernize Department of Labor oversight of the Employee Retirement Income Security Act to ensure all health insurance coverage is held to similar standards.
  • Consider a national reinsurance program to stabilize health insurance markets and improve affordability of health insurance coverage.

Alexa Gagosz is a PBN staff writer. Contact her at Gagosz@PBN.com. You may also follow her on Twitter at @AlexaGagosz.

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