AHIP chief predicts next stage of O-Care debate

The lead advocate for health insurers in Washington predicted that policymakers will eventually consider expanding access to catastrophic coverage under ObamaCare because of pressure from consumers and industry.

In an interview with National Journal, America's Health Insurance Plans President Karen Igagni said her members were concerned from the beginning about the healthcare law's limitations on high-deductible plans. 

"Individuals in the old insurance market, pre-Affordable Care Act, expressed a very, very strong preference to buy more catastrophic coverage," Ignagni told the outlet.

"So we made that point back in 2009 and 2010 that because of that preference that had been strongly demonstrated by consumers … that [set of rules] was a recipe for concern going forward. … And that's why I think there's going to be more dialogue in the policy community about how to address that concern."

The comment outlines what could be the next stage of debate over the Affordable Care Act, which establishes a level of minimum benefits that all health plans must offer.

Ignagni argued that consumers have not responded well to the requirement that they "buy up" into coverage that is more generous, and perhaps more expensive, than they really want.

"So now the question, from a policy perspective, is how do you address those challenges? Are there additional options that are offered to individuals?" she said.

"It's a question of whether or not there could be alternatives that would allow people to … purchase coverage that is, from an actuarial perspective, a little less than the actuarial value of a bronze plan," the exchanges' least-generous category of coverage that is available to everyone.

Catastrophic plans charge low premiums and high deductibles, raising the cost of routine care like prescriptions and check-ups but guaranteeing coverage for policyholders in emergencies. Consumer advocates often criticize the policies given that high deductibles can be difficult to pay when serious care is needed.

Under the Affordable Care Act, catastrophic coverage was originally just available to people under 30 and those who could not find health plans that cost less than 8 percent of their income. In December, the administration expanded access to include people whose plans were cancelled.