Morning Briefing
Summaries of health policy coverage from major news organizations
New CMS Rules Cut ACA Out-Of-Pocket Costs, Ease Special Enrollment Qualifications
Modern Healthcare: CMS: Obamacare Cost-Sharing Change Cuts Out-Of-Pocket Costs By $400
CMS on Friday significantly changed how Affordable Care Act exchanges will run next year, intending to lower out-of-pocket costs for Obamacare customers, streamline enrollees' user experience and update how insurers are paid for the risks they take on their members. In its second update to the annual benefit and payment parameters rule, the agency announced consumers' maximum out-of-pocket costs will be limited to $8,700 for individuals and $17,400 for plans that cover multiple people. The update is $400 lower than previous caps, CMS said. (Tepper, 4/30)
Fierce Healthcare: CMS Extends Special Enrollment Period Qualifications In Latest ACA Rule
The Biden administration finalized a rule that makes it easier for consumers to qualify for a special enrollment period for Affordable Care Act exchange coverage, in addition to several other major changes. The Centers for Medicare & Medicaid Services finalized on Friday the second part of the Notice of Benefit and Payment Parameters that outlines regulations on the ACA exchanges for the 2022 coverage year. A key part of the rule was more flexibility for consumers to sign up for a special enrollment (SEP) period to get coverage outside of open enrollment. (King 4/30)
Forbes: Biden’s Special Obamacare Sign-Up Already A Boon To Health Insurers
Health insurance companies may have one of their best years selling individual coverge under the Affordable Care Act thanks to a special open enrollment period implemented by the Biden administration. ... Just six weeks into the special enrollment period, the Biden administration said in early April that more than 500,000 have signed up for coverage via the healthcare.gov website, also known as the federal healthcare exchange or marketplace as insurers like to call it. Health insurers expect even more Americans to sign up to the ACA’s individual coverage, also known as Obamacare. (Japsen, 5/2)
Syracuse.Com: Federal Stimulus Covers Health Insurance For Many Who Lost Jobs, But Confusion Remains
Matthew Van Ryn has been paying $1,800 a month for health insurance since he lost his job last year at a Syracuse law firm. So he was relieved when President Biden signed the recent stimulus package, which provides six months of free health insurance to people who were forced out of jobs during the Covid-19 pandemic. But getting those benefits is more complicated than anyone would like. (Knauss, 5/3)
In other health insurance news —
MarketWatch: Why Many Nursing-Home Owners Have Escaped Scrutiny Of Their Roles In The COVID-19 Crisis
Private-equity firms have been prime targets in long-term-care reform proposals emerging during the COVID-19 crisis. But efforts to overhaul the industry are hitting a snag: that it’s tough to regulate nursing-home owners, operators and related parties when many of them remain in the shadows. A report set to be released Friday by the Roosevelt Institute, a New York think tank, underscores the problem. Arguing that private-equity firms focus on extracting profits to the detriment of patient care, the report calls on Congress to ban these firms from buying nursing homes and to require those that currently operate facilities to divest from them within five years. While the report points out that the government’s data on nursing-home ownership are incomplete, it doesn’t describe exactly how private-equity firms are to be banned from the industry when no one has a full picture of how many facilities the firms own or the corporate webs that link them with property, management and related companies. (Laise, 4/30)
AL Reporter: Report: 38 Percent Of Alabama COVID Deaths Tied To Insurance Coverage Gaps
An updated report shows that a third of COVID-19 deaths in Alabama were associated with high community rates of uninsured, while a separate report shows that Black Alabamians and women make up a disproportionate percentage of low-wage workers without health insurance. Alabama is one of 12 states that has not expanded Medicaid, and if the state were to do so, approximately 204,000 more, or nearly half of the state’s total uninsured, would gain health insurance, studies have estimated. (Burkhalter, 4/30)
Healthcare Dive: Kentucky Must Rebid Medicaid Contracts Again, Judge Rules
A Kentucky judge ruled Wednesday that the state must again rebid its lucrative Medicaid contracts previously awarded to some of the nation's largest health insurers. ... This ruling puts six insurers at risk of losing their contracts with the state. However, to prevent any disruption for the more than 1 million patients covered by Kentucky Medicaid, the current awards will remain in place for now. It's unclear when the state will begin the rebidding process. (Liss, 4/30)
Madison.Com: State Health Insurance Pool For Schools Could Save Money, Has Bipartisan Interest
Wisconsin school districts would get health insurance through a state-run program like that for state workers, potentially saving $500 million a year, under a plan in Democratic Gov. Tony Evers’ budget and in a similar proposal by an administrator for former Republican Gov. Scott Walker. (Wahlberg, 5/3)
Tampa Bay Times: Florida Lawmakers Put Brakes On ‘No Fault’ Auto Insurance
Florida motorists are one step closer to no longer having “no fault” auto insurance, after lawmakers Friday approved ditching the decades-old system and its requirement of carrying personal-injury protection coverage. ... Florida is one of just two states that don’t require some level of bodily-injury coverage. Proponents said the $10,000 in PIP coverage available in the no-fault system to help pay for health-care costs after accidents has not kept up with the times. The coverage level has been on the books since 1979. (Turner, 4/30)
