New Guidelines Would Grant States Flexibility To Use Health Law Subsidies On Plans That Don’t Meet ACA’s Requirements
Under the examples outlined by CMS Administrator Seema Verma, a state could create an entirely new subsidy program, basing aid on age, rather than income, or set income limits higher or lower than the federal requirements. But uncertainty about the validity of the guidance may mean few states will be interested in the new flexibility offered by CMS, because any state looking to implement the ideas could be sued even if the CMS approved its 1332 waiver.
The Washington Post:
New Insurance Guidelines Would Undermine Rules Of The Affordable Care Act
The Trump administration is urging states to tear down pillars of the Affordable Care Act, demolishing a basic rule that federal insurance subsidies can be used only by people buying health plans in marketplaces created under the law. According to advice issued Thursday by federal health officials, states should be free to redefine the use of those subsidies, which began in 2014. They represent the first help the government ever has offered middle-class consumers to afford monthly premiums for private insurance. (Goldstein, 11/29)
Bloomberg:
Trump To Let States Divert Obamacare Funds To Other Health Plans
“For far too long, states have looked to Washington with a ‘Mother, may I?’ approach,” said Seema Verma, the administrator for the Centers for Medicare and Medicaid Services. “Today we are saying the states have the power to make the individual markets work through innovative policies that best meet the needs of your citizens.” (Tozzi, 11/29)
The New York Times:
Federal Subsidies Could Expand To Health Programs That Violate Obamacare
The Trump administration said Thursday that states could bypass major requirements of the Affordable Care Act by using federal funds for a wide range of health insurance programs that do not comply with the law. Federal officials encouraged states to seek waivers from provisions of the law that specify who is eligible for premium subsidies, how much they get and what medical benefits they receive. (Pear and Goodnough, 11/29)
Modern Healthcare:
CMS Allows States To Get Creative With Federal Exchange Funds Under 1332 Waivers
States can use 1332 waivers to launch new financing options that resemble health savings accounts, according to CMS Administrator Seema Verma. But a former agency official warns that using any of the new flexibilities outlined could result in litigation. This new account-based program would help subsidize healthcare expenses. Under this approach, states would provide a cash contribution to an account that people can use to pay both premiums and any out-of-pocket health expenses. (Dickson, 11/29)
The Wall Street Journal:
Trump Administration Details Health-Law Waivers For States
“The specific examples laid out today show how state governments can work with HHS to create more choices and greater flexibility in their health insurance markets, helping to bring down costs and expand access to care,” said Health and Human Services Secretary Alex Azar. The flexibility being offered to states marks a fundamental shift in approach, health analysts say. The Obama administration sought to make sure people had a minimum level of coverage, while the waivers show the focus now is on making sure people have access to some kind of coverage. (Armour, 11/29)
The Hill:
Trump Administration Allows States To Loosen ObamaCare Coverage Requirements
Trump administration officials emphasized on Thursday that the pre-existing protections written into the Affordable Care Act (ACA) will not be changed. “Critics of state flexibility will always assume the worst,” Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said on a call with reporters. “The ACA’s pre-existing condition protections cannot and will not be changed.” (Weixel, 11/29)
Kaiser Health News:
Is Trump Pushing Health Insurance Innovation Or An ACA Rollback?
Policy experts predict the ideas would further foster a parallel market of cheaper, less robust coverage that could draw younger or healthier consumers, but drive up premiums for those who remain in ACA market plans. “Invariably, the coverage is going to be more expensive for people who really need comprehensive coverage,” said Timothy Jost, a retired Washington and Lee University law professor who follows the ACA closely. (Appleby, 11/29)
In other health law news —
MPR:
The MinnesotaCare Buy-In, Explained
The rising cost of health care was the top issue on the campaign trail in Minnesota this year, and the new governor and state lawmakers expect to continue the conversation when the new legislative session starts in January. For DFL Gov.-elect Tim Walz, that means looking at giving Minnesotans the option to buy-in to a public insurance program known as MinnesotaCare, and he could get some support from new DFL House members. (Bierschbach, 11/29)
Milwaukee Journal Sentinel:
Republicans To Take Up Pre-Existing Conditions Bill In Lame-Duck Session
Republican lawmakers plan to pass a measure to protect coverage for pre-existing conditions as soon as Tuesday as part of a lame-duck session that could also curb the powers of the incoming Democratic governor. The move comes less than a month after Gov. Scott Walker and other top-of-the-ticket Republicans lost their election bids amid a wave of criticism for their fights against the Affordable Care Act, which is also known as Obamacare and guarantees coverage for pre-existing conditions. (Marley, 11/29)
Kaiser Health News:
Short On Federal Funding, Obamacare Enrollment Navigators Switch Tactics
Enrollment is down sharply on the federal health insurance marketplace this fall, and the consumer assistance groups that help with sign-ups think they know why. They don’t have the staff to help as many customers as before because the Trump administration slashed funding. The federal government is spending $10 million this year on navigators who help individuals enroll in coverage. The government spent $36 million in 2017 and $63 million in 2016. (Galewitz, 11/30)
Kaiser Health News:
Listen: Paying More For Your Health Insurance? Depends On Where You Live
Open enrollment is underway in the sixth year of the Affordable Care Act’s insurance marketplaces, with some regions of the country experiencing unexpected drops in premiums and others weathering higher prices. In California, premiums for plans sold through the state’s health insurance exchange, Covered California, will rise an average of 8.7 percent next year, although individual rate increases — or decreases — depend on a variety of factors, including where you live, what plan you choose and your income. Many consumers can save money by switching plans. (11/29)
Concord (N.H.) Monitor:
N.H. Enrollment In Federal Health Care Marketplace Lagging Behind Last Year
Slightly more than 11,400 New Hampshire residents have bought health insurance plans through the federal marketplace so far in the open enrollment period, and since this year has a relatively short sign-up period, it seems likely that the final tally will be lower than last year’s figure of about 51,000. New Hampshire’s experience is echoing that of many of the 39 states using the healthcare.gov platform, most of which have seen fewer sign ups than at this point last year. New Hampshire residents who want to purchase coverage on healthcare.gov, and thus be eligible for federal subsidies, must do so by Dec. 15. (11/29)
