Obamacare stabilization funds left out of $1.5 trillion budget deal

On Friday, March 23rd, President Trump signed a $1.5 Trillion budget deal to fund the government through September 2018. While the bill boosted funding for several federal agencies, including the National Institutes of Health and the Department of Health and Human Services, it did not include any funds to help stabilize the health insurance market.   

Sen. Lamar Alexander (R-TN) and Sen. Patty Murray (D-WA) had been working on a bipartisan plan to stabilize the health insurance market, but the plan was ultimately left out of the final budget deal.  

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Stakeholders are in standby after DOL’s proposed association health plan regulation comment period

After the end of the Department of Labor’s (DOL) comment period for its planned expansion of association health plan eligibility, the healthcare community awaits a decision.  

The regulation would broaden access to AHPs by allowing employers to form an association on the basis of geography or industry, instead of only industry, trade, or professional association. It would also allow sole proprietors to join AHPs. According to a recent Avalere Health analysis, the proposed rule would have the following impacts 

  • Higher premiums for individual and small group – Premiums are projected to rise in the current individual (2.7% – 4%) and small group (0.1% to 1.9%) markets, relative to current law. This would be largely due to healthier employees shifting to AHPs  
  • Increased number of uninsured – An estimated 130k to 140k individuals will become uninsured, mostly due to increasing premiums in the individual market as healthier individuals move to AHPs.   
  • Additional 2.4M to 4.3M enrolled in AHPs – This represents members switching from the individual market (0.7M to 1.2M) and small group market (1.7M to 3.2M) into the expanded AHPs.   
  • Lower premiums for AHPs – Premiums in the new AHPs are projected to be between $1,900 to $4,100 lower than the yearly premiums in the small group market and $8,700 to $10,800 lower than the yearly premiums in the individual market by 2022. 

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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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