Improve the health of the people of Wisconsin by supporting and strengthening physicians' ability to practice high-quality patient care in a changing environment.

Society weighs in on proposed changes to ACA payment rules

The Wisconsin Medical Society submitted comments to the Department of Health and Human Services (HHS) this week on proposed changes to the Affordable Care Act’s (ACA) payment rules. The proposed rule includes changes and updates to premium adjustment factors, required contributions, limits on cost-sharing, prescription drug benefits, discrimination regarding medication-assisted treatment (MAT) and special enrollment periods, among others.

In its comments, the Society urged HHS to look at ways to keep patient premiums low while also lowering out-of-pocket costs and ensuring that patients can acquire adequate coverage.

“Patients are increasingly feeling the strain of higher out-of-pocket costs due to increasing deductibles, copays and premiums, which are rendering many people functionally underinsured,” the letter states. “The Society urges HHS to look at other ways to reduce federal expenditures without negatively impacting patients by increasing premiums or jeopardizing access.”

Conversely, the Society supported HHS’s efforts to allow insurers to make mid-year changes to their formularies provided changes don’t negatively impact patients. The Society also supported HHS’s efforts to crack down on insurer discrimination against medication-assisted treatment and to create new special enrollment periods for people whose income decreases during the year.

Click here to read the full comment letter. Contact H.J. Waukau in the Society’s Advocacy and Member Relations department if you have questions.

Back to February 21, 2019 Medigram