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Friday, December 14, 2018

NCCI Holds its First Briefing – A Bipartisan Event with Experts from Families USA and the American Enterprise Institute

Three out of four uninsured Americans are eligible for coverage through state and federal health care programs, yet they remain unenrolled. More than a third of the uninsured (38 percent) are missing out on a chance to receive coverage that is essentially free: either Medicaid, the Children’s Health Insurance Program (CHIP), of qualified health plans with premiums that are fully covered by premium tax credits.

This discrepancy between eligibility and enrollment represents an enormous opportunity to rapidly increase coverage through a pragmatic policy – automatic enrollment of eligible people into coverage – that has historically possessed a great deal of support across-the-aisle. The transformative and immediately applicative nature of this solution also goes to the very heart of what Families USA wishes to achieve with its recently launched National Center for Coverage Innovation (NCCI), which is dedicated to fixing the coverage gaps we face today. 

This bipartisan energy was on full display during a discussion of auto-enrollment policy on the Hill on December 11th. The briefing was the latest product of an ongoing collaborative effort between Stan Dorn, JD, Senior Fellow at Families USA and the Director of the NCCI, and James Capretta, Resident Fellow at the American Enterprise Institute and holder of its newly endowed Milton Friedman Chair. Earlier this year, Stan and Jim, along with Lanhee Chen, PhD, who is the David and Diane Steffy Research Fellow at the Hoover Institution, published two articles in Health Affairs describing their recommendations on auto-enrollment. You can read those articles here, and here.

The briefing was hosted and attended by Rep. Ami Bera, MD (CA-7). Dr. Bera, who has earned a reputation as one of the most thoughtful legislators working on health care issues today, best captured the atmosphere in the room by saying: “Given the folks at the table, you can tell it’s a bipartisan concept!”

Stan and Jim – both leading experts on enrollment policy – channeled this sentiment by outlining a number of auto-enrollment strategies that could be adopted on a bipartisan basis at both the federal and state level as early as next year. 

Framing the issue as one of overcoming the universal human drive to avoid excessive paperwork, Stan stressed examples of successful past use of auto-enrollment, including with 401(k) retirement savings accounts, children’s health coverage provided through Medicaid and CHIP, and Medicare Part D low-income subsidies. Stan also advocated for giving state health systems access to federal health care and income data, increasing states’ ability to determine eligibility and provide coverage without asking consumers for needless paperwork.

In turn, Jim urged members of Congress to create a federal platform encouraging states to experiment with auto-enrollment strategies, including resources to develop necessary information-technology infrastructure. Hopefully, these state-level experiments would, after a period of five years or so, ultimately reveal best practices that could help reform the system nationally.

When taken collectively, these proposals present a technocratic auto-enrollment agenda for 2019 that could vastly increase enrollment on a bipartisan basis. 

Read more about National Center for Coverage Innovation’s ideas for state action in 2019.