PBGH Encourages Congress to Prioritize Health Care Affordability and Access in Budget Reconciliation Process
Purchaser Business Group on Health (“PBGH”), a non-profit coalition representing 40 private employers and public purchasers across the United States, urges Congress to prioritize health care affordability and access in budget reconciliation.
PBGH and its member organizations are intently and consistently focused on the rising cost of health care, with affordability and access emerging as top priorities in PBGH’s Annual Member Survey and 2025 Purchaser Policy Priorities. Accordingly, PBGH is greatly concerned about the potential loss of coverage due to proposed reductions in Medicaid spending and Marketplace eligibility restrictions for those enrolled in the Affordable Care Act’s plans. Policies that increase uninsured rates will put strain on our health care system that could directly and indirectly harm affordability and access in the commercial market.
According to the nonpartisan Congressional Budget Office (“CBO”), these proposed changes to Medicaid and the Marketplace will increase the number of uninsured by an estimated 8.6 million individuals over the next 10 years. Studies consistently show uninsured patients are more likely to forgo necessary care, like cost-effective preventive services. A sick and unhealthy population is a burden on taxpayers, local communities and our nation’s economic potential.
Regarding affordability, up to 20% of the costs of uncompensated care are passed onto private sources (including employers) and can result in higher premiums, cost-sharing, and decreased access for commercially insured Americans. Research shows that prices in the commercial market, which are already high and unsustainable for employers and patients, may increase even further. Additionally, public and private purchasers know firsthand from their health plan’s negotiations that strained hospitals and health systems often use this as leverage in contract negotiations to advocate for higher prices.
Regarding access, reductions in Medicaid and Marketplace coverage especially threaten health care access in rural areas, where financially distressed hospitals and clinics could face closures. Hospitals serve everyone in a community, so each closure jeopardizes access to critically important care for patients regardless of their insurance status. Furthermore, reduced patient access leads to worsening health outcomes and higher costs. This is especially true for pregnant and post-partum women seeking maternal care. Employers need their employees who live and work in rural communities to have access to high-quality care.
While PBGH appreciates Congress’ intent to lower the tax burden on Americans and decrease the federal deficit, the proposals on the table to pay for the extension of the Tax Cuts and Jobs Act are misguided. As Congress negotiates its legislative package for budget reconciliation in the coming weeks, PBGH urges lawmakers to reduce spending in ways that improve health care affordability and access for all patients. The current bill’s expansion of HSAs to be compatible with direct primary care – as well as the inclusion of certain Medicare and Medicaid PBM reforms which could be built upon for the commercial market – are good measures to this end. Many other bipartisan health care reforms, such as comprehensive site neutral payments, could greatly increase affordability and access and would make the market more competitive.
PBGH is a trusted resource Congress can leverage as it seeks to reform the U.S. health care system in ways that improve affordability and access for Americans.
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About Purchaser Business Group on Health
PBGH is a non-profit coalition representing 40 private employers and public entities across the U.S. that collectively spend $350 billion annually purchasing health care services for more than 21 million Americans and their families. In partnership with its members, PBGH initiatives are designed to test innovative operational programs and scale successful approaches that lower health care costs and increase quality across the U.S.