By Rachel Schwab, Emily Curran, and Sabrina Corlette

Health care played a huge role in the midterm elections, making frequent appearances as a central policy priority in candidate platforms and cited as a top issue among voters. As state legislatures across the country prepare to convene in 2019, improving access to affordable health coverage will likely be on the agenda. Several newly elected officials have expressed an interest in establishing a state reinsurance program, following in the footsteps of a handful of states who have utilized the Affordable Care Act’s 1332 waivers for this purpose. As reinsurance gains ground as a state-level effort to promote market stability, stakeholders can learn from the experience of states that have already implemented reinsurance programs.

In a new report from Georgetown, authors Rachel Schwab, Emily Curran, and Sabrina Corlette evaluate progress of the three states that have operational reinsurance programs: Alaska, Minnesota, and Oregon. To assess the effectiveness of these programs, the authors reviewed rate filings and 1332 waiver applications and interviewed state regulators and insurer representatives in all three states to determine whether the programs have met their stated goals. Findings include:

• Reinsurance programs have been largely effective in achieving their aims, particularly in stabilizing individual market premiums and maintaining insurer participation.
• While reinsurance has widespread support, state funding remains an issue.
• Lessons learned for other states include the importance of leveraging state infrastructure and expertise, communications with federal partners, and the need for ongoing monitoring and assessment.

To read more about these and other findings, see the full report here.

The report was made possible thanks to the generous support of the Robert Wood Johnson Foundation and Altarum.