…in their insurance markets. Their experience was not pretty. Looking Ahead Senate Majority Leader Mitch McConnell has said the Graham-Cassidy bill will be brought up for a vote in the Senate next week. CBO’s estimates of the bill’s impact on cost and coverage may not be available for weeks, but it’s likely to show coverage losses at least as great…
…18 states declined to provide marketplace plan oversight, lack the authority, and/or have extremely limited staff and expertise to do the job. HHS under the Obama administration conducted plan management in order to fill gaps in state authority or oversight. The removal of a federal regulatory backstop could mean that key criteria for plan certification could receive little or no…
…benefits, Medical loss ratio rebate program, Direct enrollment through web-based brokers, and Minimum essential coverage Many states will have an interest in picking up a greater role in health plan enforcement and oversight of federal protections in order to ensure that consumers continue to receive the benefits promised under the ACA, as well as to promote stable, well-functioning insurance markets….
…include: An uncertainty that the cost sharing reduction subsidies (CSRs), which reduce out of pocket expenses for eligible enrollees, will be honored.Corlette says that a loss of subsidies could be a factor in significant premium increases for those who purchase insurance on their own. The potential lack of IRS enforcement of the individual mandate, an additional tax that must be…
…review rates in the absence of a decision on the fate of CSR funding. Insurers are on the hook under the ACA to lower cost-sharing for eligible individuals as a condition of participating in the marketplaces, whether they’re reimbursed with federal funds or not. A mid-year loss of CSR funding might prompt issuers to leave the marketplaces rather than absorb…
…enforcement of the individual mandate, arguing that it would encourage broad participation in the markets, particularly among younger and healthier consumers. States also pointed out that enforcing the mandate would be the most effective means of “promoting continuous coverage” and stabilizing the marketplaces. Alaska and Wisconsin also suggested modifications to the medical loss ratio (MLR) rules to allow insurers to…
…“grandfathered” plans, plans that predated the ACA and do not have to comply with many of the law’s reforms. “Level funded” products marketed to healthier groups. Insurers have ramped up the marketing of level-funded products that combine self-funding, a stop-loss policy, and administrative services. These products are targeted to small employers that have relatively young and healthy workers. They are…
…out people with pre-existing conditions and do not have to cover EHB. These plans would then become more attractive to healthy people, and they could charge significantly lower premiums than ACA-compliant plans. This would, in turn, given insurers an incentive to stop offering ACA-compliant plans and leave consumers with pre-existing conditions or who need more comprehensive coverage with fewer options…
On July 18, Unitedhealthcare reported its second quarter (Q2) financial earnings, kicking off the Q2 cycle in which health insurers will announce their quarterly results, detail major financial gains and losses, and provide insight into how they expect to perform over the following quarter. While the audience for these reports is mainly financial analysts, and calls are carefully scripted to…
…a consumer tries to enroll in a plan through a SEP, he or she will be required to verify the life event that qualified them for the SEP. The rules also tighten eligibility for SEPs for certain common qualifying events such as loss of minimum essential coverage and marriage. Additionally, marketplace enrollees that qualify for a SEP now have a…
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
