Recently, there’s been news coverage of the Trump Administration’s latest attempts to undercut enrollment in the exchanges by cutting many of the outreach, education, and enrollment activities that took place during prior open enrollment periods. But these are merely new tactics in the administration’s ongoing effort to sabotage the Affordable Care Act (ACA). These tactics—some questionable in their legality—are unlikely to stop before the next open enrollment period.
After the most recent collapse of Senate efforts to repeal the Affordable Care Act (ACA), many in Congress, on both sides of the aisle, see an opening for bipartisan health reform. Rather than take insurance away from tens of millions of Americans through sweeping legislation rushed through on a straight party-line vote, some lawmakers now propose to stabilize health insurance markets through careful, bipartisan policymaking.
To help people who currently receive health coverage through the individual insurance market, a well-constructed stabilization package could slow the rise of premiums, guarantee financial assistance, and increase the availability of meaningful health insurance options.
For months, President Trump has been threatening to cancel so-called called “cost-sharing reduction” payments, or CSRs. This is apparently part of his brazen strategy to “implode” health insurance marketplaces and force Democrats to negotiate about the Affordable Care Act’s (ACA) future. CSR payments cover insurers’ cost of lowering deductibles and other out-of-pocket costs for almost 6 million marketplace enrollees in low-wage, working families.
On August 15, the Congressional Budget Office (CBO) released its analysis of what would happen if CSR payments were eliminated.
Iowa has asked the federal government to approve a proposal to make troubling changes to its marketplace that will increase coverage costs for low- and middle-income Iowans. It essentially takes federal funds intended to help people afford the cost of health insurance and uses them to pay insurance companies and to offer subsidies to relatively high-income people. The risky and harmful proposal fails to meet key requirements and should be rejected.
Several states are now pursuing 1332 waivers. We have heard about several helpful proposals, and at least one that is troubling.
On the positive side, Alaska’s reinsurance waiver was recently approved. This waiver will allow Alaska to pass through federal savings resulting from the state’s reinsurance system. Partly as a result of this system, Alaska’s individual market insurer has proposed a 22 percent reduction in premium rates for next year.