Insurers Could Be On The Hook For CSR Funds They’ve Already Spent On Low-Income Enrollees
The companies may have to return any surplus they used to cover cost-sharing reduction costs since the Trump administration cut off the payments in October.
Modern Healthcare:
CMS Could Demand CSR Repayments From Insurers If Congress Doesn't Act
Insurers may be on the hook to pay back the government for funds they have already spent on low-income enrollees through 2017. It's still not clear whether Congress will appropriate cost-sharing reduction payments, as lawmakers race toward a short-term spending agreement before Christmas. This means insurers may have to return any surplus they used to cover CSR costs since the Trump administration cut off the payments in October. An October bulletin from the CMS said insurers would be on the hook for any "overpayments" of CSRs for 2016, but that the agency wouldn't pay any shortfalls. This could be the case for 2017, according to a healthcare attorney who follows the CMS' regulatory actions closely. (Luthi, 12/7)
In other health law and marketplace news —
Chicago Tribune:
Q&A: Illinois Insurance Department Head Navigates Obamacare Changes
Jennifer Hammer’s first year as director of the state’s Department of Insurance hasn’t been an easy one. Hammer, who was appointed by Gov. Bruce Rauner and confirmed in February, has overseen the department during a time of tumult and uncertainty over the Affordable Care Act, also known as Obamacare. Hammer, 35, has been at the department’s helm as it reviewed proposed rates for Obamacare plans for next year, worked with insurers to handle changes made by the Trump administration and unveiled a revamped website to help Illinois residents enroll. The deadline for Obamacare enrollment is Dec. 15. (Schencker, 12/7)
Kaiser Health News:
For Marketplace Customers Who Delay, Auto-Enrollment Could Be Nasty Wake-Up
Shopping to update your coverage on the health insurance marketplace may be annoying — didn’t you just do this last year? But letting the exchange automatically renew your coverage instead could be a big mistake. If you don’t like the plan you’re auto-enrolled in this year you may be stuck with it in 2018, unlike previous years when people could generally switch. (Andrews, 12/8)
Kaiser Health News:
Challenges Abound For 26-Year-Olds Falling Off Parental Insurance Cliff
Marguerite Moniot felt frustrated and flummoxed, despite the many hours she spent in front of the computer this year reading consumer reviews of health insurance plans offered on the individual market in Virginia. Moniot was preparing to buy a policy of her own, knowing she would age out of her parent’s plan when she turned 26 in October. (Heredia Rodriguez, 12/8)
Kansas City Star:
One Of The Obamacare Insurers Erroneously Said Children’s Mercy Was In Its Network
During the first four weeks of the Affordable Care Act open enrollment period the website for Ambetter, a new insurer offering plans in the Kansas City area, said that some Children’s Mercy Hospital practitioners were in its network. They were not. (Marso, 12/7)
