Proposed rule could provide an extra $10 billion for reinsurance

As Congress struggles to keep the federal government open, analysis continues surrounding how to help stabilize the Affordable Care Act (ACA). Oliver Wyman and the Congressional Budget Office (CBO) suggest that the federal reinsurance funds would reduce premiums for years to come.

A Cost sharing reduction (CSR) is a discount that is applied to the individual’s health insurance premium which lowers the amount the member must pay for deductibles, copayments, and coinsurance. “The proposal to fund the CSRs would lower federal spending enough to pay for the reinsurance program and leave about $2 billion extra” says Senate health committee Chairman Lamar Alexander.

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Congress releases bipartisan plan to stabilize Obamacare markets while lawmakers race to avoid government shutdown

Congressional Republicans unveiled legislation on Monday that that would help stabilize the Obamacare health insurance markets for Insurers. If enacted, the new bill would fund insurer payments known as cost-sharing reduction payments for three years and offer $30 billion in reinsurance funds distributed evenly for three years. It includes more flexibility for states to implement changes to their healthcare systems and allows more people to buy plans that have lower premiums and higher deductibles. 

Sen. Lamar Alexander (R-Tenn.) is one of the main champions of the proposal, arguing that it will help bring down premiums this fall. 

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Proposed regulations could see 4.3M new members for Association Health Plans

proposed rule from the US. Department of Labor (DOL) could lead to a significant increase in the number of members enrolled in Association Health Plans (AHPs) and, in turn, decrease membership and increase premiums for individual and small group markets. 

Currently, AHPs are health insurance arrangements sponsored by an industry, trade, or professional association that provide health coverage to their members. These offer an alternative to small businesses and individuals who are part of a larger industry or association. However, due to the current limitations – individual enrollees who are sole proprietors and small employers who are engaged in a specific trade or business – many people are not eligible to participate in AHPs.  

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1332 State Innovation Waivers: Current status & potential opportunities

Section 1332 waivers, or state innovation waivers, allow states to apply to the federal government to waive certain provisions of the Affordable Care Act (ACA). This can allow the states to pursue innovative strategies for providing residents with access to quality, affordable insurance, while retaining the law’s basic protections. In this blog we evaluate state’s waiver approval statuses. 

Below is our analysis for states with approved, pending, and withdrawn requests.

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Does the Healthy Indiana Plan 2.0 have national aspirations?

For the last six years, the Healthy Indiana Plan (HIP) has delivered quality care, encouraged the use of preventive services, and received measurable results. By incorporating the essence of a high deductible health plan and health savings account (HSA), the Medicaid expansion project became the first in the nation to adopt – and successfully demonstrate – the linkage of personal responsibility with subsided health protection to low-income individuals.

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Trump Administration releases guidance on Medicaid work requirements

What happened?  

In a major shift that could affect millions of low-income people receiving benefits, The Trump Administration announced Thursday, January 11, that it will open the door for states to require work requirements for Medicaid recipients.  

The guidance was published in a letter from CMS Deputy Administrator Brian Neale to State Medicaid Directors Thursday morning. In the letter, Deputy Administrator Neale stated that the move would help “improve Medicaid enrollee health and well-being through incentivizing work and community engagement.” 

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Alex Azar on track to become next HHS Secretary

Following yesterday’s Senate Finance Committee hearing, it appears Alex Azar, the former head of Pharmaceutical company Eli Lilly’s U.S. operation, is on track to be confirmed as the Head of the Department of Health and Human Services (HHS). If confirmed, Azar will replace Thomas Price M.D., a former congressman who served as the HHS secretary for seven months before resigning. 

Despite a probe by Democrats, including that from Sen. Ron Wyden (D-Oregon), on his drug industry ties, Republicans have focused on the fact that Azar would come to the job with greater working knowledge of the sprawling agency, with its budget of more than $1.1 trillion and far-flung staff of nearly 80,000, than many of his predecessors, according to the Washington Post 

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