Access to health care in the event of national disaster or emergency: A policy investigation

The occurrence of national disasters and other emergencies leads to the problem of providing consistent and affordable access to health care for displaced individuals. When individuals are displaced, they are often no longer able to utilize their traditional care providers, leading to difficulty in finding a provider willing to accept their insurance as well as the accrual of out-of-network costs. These barriers may lead individuals to underutilize necessary non-emergency care for the duration of their displacement. This paper explores the current policies surrounding the regulation of health insurance during public health emergencies and identifies opportunities to develop new policies to address the barriers to access met by displaced individuals. The public insurance sector has already addressed the problem of providing consistent and affordable access to care for displaced individuals through the use of Section 1135 waivers by the Secretary of Health and Human Services. Currently, no analogous process exists to regulate private insurance in the event of national disaster or emergency. The establishment of criteria for certification for health insurance plans within state insurance exchanges by the HHS Secretary provides an opportunity to regulate the emergency response policies of these plans. This paper identifies the potential policy solution of including a structure similar to Section 1135 waivers as a requirement for insurance plan participation in exchanges to develop a standardized process for response to disasters and emergencies for all plans in the exchanges and to reduce the barriers to health care faced by individuals displaced by these events.