New Guidance on Section 1332 waivers, issued in October 2018, can undermine key consumer protections and pave the way for federal dollars to subsidize plans that provide few benefits. The public can comment on the federal guidance through December 24, 2018. People should also find out if their states are developing waiver proposals, and comment on those to both the state and federal governments. This analysis explains what issues to watch.
On October 10, 2018, the Trump administration published a proposed rule in the Federal Register that would make it much harder for immigrants to obtain visas (including visas to study or work in the U.S.), extend their visas, or adjust their status to become lawful permanent residents.
The Trump Administration’s Continued Attacks on Immigrant Children and Families: Dismantling the Flores Settlement Agreement
On September 7, the Trump administration took another step toward eliminating basic protections for immigrant children and their families who enter the U.S. without documentation—including those legally seeking asylum, by issuing a notice of proposed rulemaking (proposed regulation) that would dismantle constitutional protections for children established by the Flores Settlement Agreement governing the detention and treatment of children in U.S.
NOTE (January 17, 2019): From August through December 2018, Arkansas disenrolled over 18,000 from Medicaid for failure to meet the work hours reporting requirement. Each individual disenrolled was locked out of Medicaid coverage from the point of disenrollment until January 2019, when they can reapply for coverage. At the point individuals re-enroll, the three month “clock” for reporting work hours begins again.
Update: Judge O’Connor heard oral arguments in Texas v. United States on September 5, summarized in this Health Affairs article. It is not clear how quickly the judge will rule on a preliminary injunction. The Department of Justice, despite arguing to undo preexisting condition protections, has admitted that a negative decision, even if appealed, would bring chaos and uncertainty during open enrollment this fall.
Last week, the Trump administration announced a second round of drug pricing proposals that, while relatively modest on their own, take important steps toward future reforms that could significantly reduce prices now burdening both consumers and the overall health care system.
On July 7, the Centers for Medicare and Medicaid Services (CMS) announced a policy change that could fundamentally undermine the individual market, endangering health care for millions of people who get health care through the individual marketplace. CMS announced it will not distribute more than $10 billion out of a "risk adjustment" pool which is funded by insurers who participate in the individual and small-business markets. The risk adjustment program collects funds from insurers that cover healthier people and redistributes those funds to plans that have sicker enrollees.
The Trump administration’s zero-tolerance policy went into effect on April 6, separating children from parents who arrive without documentation—including those legally seeking asylum--at the U.S. border. Between April 19 and May 31, 2018, nearly 2,000 children were separated from their parents under the new policy. Although not the first administration to separate immigrant children from their parents, the Trump administration’s zero-tolerance policy means that the practice of separating families has grown dramatically and will continue to grow, overwhelming an already precarious system, with devastating consequences for children, families, neighborhoods, and communities across the country.
What we know without a doubt is that separating children from their parents is harmful to children, traumatic for families and goes against our basic American values. This Trump administration must stop this cruel practice and instead put the best interest of children and families ahead of its own political agenda. The president can and should immediately end this practice of family separation.
Much of the report’s media coverage has focused on the projected 15 percent premium increase for 2019 as a measure of the damage being done by the Trump administration and its Republican allies in their ongoing campaign to sabotage health insurance markets. In truth, this sabotage has imposed a much higher cost on millions of families in America.