Affordable Care Act

ACA Individual Mandate Repeal Could Cut Insured Number By 13M

by Thomas Beaton

As a potential repeal of the ACA’s individual mandate faces the US Senate, the Congressional Budget Office (CBO) and Joint Tax Committee (JTC) found that a repeal would cut the number of insured...

Reinsurance Changes Payers Can Expect Under the ACA in 2018

by Thomas Beaton

ACA federal reinsurance policies have undergone a transformation since their introduction from four years ago. Payers should continue to prepare for larger changes of federal and state ACA reinsurance...

ACA Open Enrollment Rate Expected to Drop Up to 13% in 2018

by Thomas Beaton

Analysts expect up to a 13 percent drop in open enrollment on the ACA marketplace exchange in 2018,  according to Standard and Poor’s Global (S&P Global). Only 10.1 million to 11.4...

Providers Seeing Even Mix of Public, Commercially Insured Patients

by Thomas Beaton

Providers are seeing a fairly even mix of Medicare, Medicaid, and commercially insured patients with fewer uninsured individuals than before the ACA, according to the AMA’s Physician Practice...

Before CSR Cuts, ACA Health Plans Expected Stable Premiums

by Thomas Beaton

Had cost-sharing reductions (CSRs) under the Affordable Care Act remained in place payers would only expect modest premium increases with some continued profitability, a USC Brookings...

CBO: Alexander-Murray Healthcare Bill Could Save $3.8B

by Thomas Beaton

The Bipartisan Health Care Stabilization Act of 2017, also known as the Alexander-Murray compromise bill, would save the federal government $3.8 billion without drastically changing the number of...

Alexander-Murray Bill Offers ACA Market Stabilization, Flexibilities

by Thomas Beaton

A new bipartisan bill proposed by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) is an attempt to stabilize and protect provisions of the ACA while allowing for greater state flexibility to...

Iowa Withdraws 1332 Waiver for Insurance Market Stabilization

by Thomas Beaton

Iowa Insurance Commissioner Doug Ommen has withdrawn his state’s application for a 1332 waiver to stabilize its insurance markets in 2018.   The proposed stopgap measure  included a...

Bipartisan Senate Compromise May Reinstate CSRs, Alter 1332 Waivers

by Thomas Beaton

Senators Lamar Alexander (R-TX) and Patty Murray (D-WH)  have floated a bipartisan deal to reinstate the ACA’s cost-sharing reductions (CSRs) and boost individual enrollment outreach in...

States Approve Premium Hikes after Loss of Cost Sharing Reductions

by Thomas Beaton

Several states have decided to either increase or maintain expected premium increases on individual and small group plans following the President’s decision to end the cost-sharing reductions...

Payers Express Concern Following Cost-Sharing Reduction Cuts

by Thomas Beaton

Several payer organizations have expressed deep concerns after President Trump announced plans to end the cost-sharing reduction (CSR) subsidies for ACA individual plans. Organizations including AHIP,...

Trump Plans to End Cost Sharing Reduction Subsidies for Payers

by Jennifer Bresnick

The White House has announced plans to scrap the Affordable Care Act cost sharing reduction subsidies for health insurers that have helped to keep premiums low and stabilize markets subject to the...

Senate to Vote on Funding CHIP for Five Additional Years

by Thomas Beaton

A bipartisan bill to continue CHIP funding for five more years and transition to a state-federal partnership will move to a Senate vote after being approved by the Senate Finance Committee.   The...

HHS Nixes Proposed Rule for Health Plan Compliance Documents

by Thomas Beaton

HHS has withdrawn a proposal for a rule that would have required controlling health plans (CHPs) to submit additional information and documentation demonstrating compliance with HHS operating rules,...

Blue Shield of CA to Offer Statewide Healthcare Provider Directory

by Thomas Beaton

Blue Shield of California plans to develop a statewide healthcare provider directory, with the help of Integrated Healthcare Association (IHA), that gives members access to current information on...

NB and IA Offer New Individual Market Plan For Open Enrollment

by Thomas Beaton

An new individual market plan created out of Medica and CHI Health will be available to consumers during the open enrollment period in Nebraska and Iowa, the health networks announced in a press...

Medicaid Directors Voice Concerns for Graham-Cassidy Bill

by Thomas Beaton

The National Association of Medicaid Directors (NAMD) argues that a hasty passage of the Medicaid reforms presented in the Graham-Cassidy bill will have significant consequences for public payer...

Planning for Individual Insurance Exchange Stabilization in WA

by Thomas Beaton

State health insurance markets and their individual insurance exchanges have faced regular instability in the form of payer exits, imbalanced risk pools, and rising premiums that push out new and...

AHIP: Graham-Cassidy Bill a Poor Choice for Payers, Patients

by Thomas Beaton

AHIP believes that passage of the Graham-Cassidy Bill making the rounds in the Senate would adversely affect payer market through policies that destabilize the health insurance markets, reduce patient...

Veterans Gained Coverage under ACA, but May Lose Big from Repeal

by Thomas Beaton

While the Affordable Care Act (ACA) produced significant coverage gains for veterans, currently proposed repeal actions could hit this population particularly hard, according to a study from RAND...