Employers have found yet another way to cut costs by shifting operating expenses onto the government and tax payers.
Moving even a few high-risk patients to exchange coverage could add millions of dollars in costs to those plans. The costs would be passed on to customers in the form of higher premiums and to taxpayers in the form of higher subsidy expense. By shrinking the hospital and doctor network to make the company plan unattractive to those with chronic illness or raising co-payments for drugs needed by the chronically ill, companies could make the plan unattractive, effectively pushing high-cost workers to look at other options.
“Shifting high-risk workers out of employer plans is prohibited for other kinds of taxpayer-supported insurance. For example, it’s illegal to induce somebody who is working and over 65 to drop company coverage and rely entirely on the government Medicare program for seniors, said Amy Gordon, a benefits lawyer with McDermott Will & Emery. Similarly, employers who dumped high-cost patients into temporary high-risk pools established by the health law are required to repay those workers’ claims to the pools. “You would think there would be a similar type of provision under the Affordable Care Act” for plans sold through the marketplace portals, Gordon said. “But there currently is not.””
Read the full NPR story here.