What is the “Keep Your Plan” Bill and How Does it Affect Physician Practices and Patients?

Earlier this month, the House of Representatives approved the "Keep Your Plan" Bill, which is an amendment to the Affordable Care Act. The controversial amendment essentially lengthens the ACA's transition policy, allowing insurers to continue selling coverage that does not meet the requirements of the ACA for another five years. While many argue the bill was created to undermine the ACA, others contend the amendment will help small businesses and employees meet the new coverage guidelines with less hardship. Like most of health care reform, the merits of legislation can be debated endlessly. At the end of the day, however, we know physicians need to know how legislation affects them and their patients. Here's what you need to know.

Five More Years

The ACA allowed for non-compliant plans to still be used through 2016, as long as they were purchased before 2013. The "Keep Your Plan" bill allows insurers to sell group plans that do not meet all the requirements under the ACA for another five years, through 2019. Here's where it gets tricky. The ACA only allowed for the continuation of already existing non-compliant plans. The new bill allows groups to continue to purchase non-compliant plans through 2019. 

Implications

For small businesses and other group plan members, they may be able to keep their current coverage until 2019 and even purchase new plans that are non-compliant. That means providers may continue to have patients with plans that do not meet ACA requirements until 2019. As most providers know, this affects billing and treatment, and can create confusion among patients. Patients often accept or deny treatment, especially preventive care, based on how much it will cost them. For example, treatment such as wellness visits and preventive care are required to be covered under the ACA. However, these non-compliant plans will not be required to cover everything the law mandates. Providers will have to continue their due diligence when recommending treatment, and inform patients about costs and what this may mean to their medical bill.  Essentially, medical practice management will remain somewhat complicated.

However, the Bill has not passed the Senate yet. Many are predicting it will not since Democrats are still in control. However, 25 House Democrats broke ranks and voted in favor of the bill. We'll be watching closely to see what happens.