Today, Pam MacEwan, CEO of the Washington Health Benefit Exchange, issued the following statement on the signing of House Bill 2516:
“The Washington Health Benefit Exchange applauds today’s signing of House Bill 2516 by Gov. Jay Inslee.
“This state-level legislation protects important progress made in Washington state under the Affordable Care Act. Our position as the state’s health insurance gateway is now stronger than ever, and despite continued uncertainty we may see at the federal level, this bill enables us to continue improving the customer experience for the people in our state.
Last fall, Dem Senator Patty Murray and GOP Senator Lamar Alexander (among the few Republican Senators actually interested in improving the ACA) got together and hammered out a deal called Alexander-Murray. At the time, the bill would have done the following:
Two years of subsidy funding, along with funding for the rest of 2017. There will also likely be additional steps to help enrollees with their premiums in 2018.
A "copper plan" for people older than 30, which would be less comprehensive than other ACA plans but would have a lower premium.
$106 million in enrollment outreach funding in 2018 and 2019.
Shorter review time for states seeking waivers from some of the ACA's coverage requirements. It's unclear what other waiver changes have been agreed to at this time.
Authorization for funding to help states launch reinsurance programs, which would defray the costs of covering the sickest consumers.
Of these five items, it's really the first two which would have the biggest impact: CSR reimbursement payments and a low-end "Copper Plan".
I should note up front that despite the snarky headline, this is actually good news on the whole, and Premera does deserve some credit for it since part of the $250 million they refer to below is voluntary on their part.
Premera Blue Cross, the sole carrier offering ACA exchange individual market policies throughout the entire state of Alaska, and one of the major carriers on the indy market in Washington State, posted this press release today:
Premera Announces $250 Million Investment In Customers and Community
Mountlake Terrace, Wash. — (March 12, 2018) — Premera Blue Cross, a leading health plan in the Pacific Northwest, today announced $250 million in investments over five years across Washington and Alaska to help stabilize the individual market, improve access to care in rural areas and support local communities in their efforts to address the behavioral health issues impacting their residents.
Former CMS representative and current healthcare policy advisor for Sen. Brian Schatz, Aisling McDonough, made an important point last night:
If you have a pre-existing condition and live in a rural area, especially in VA, TN, OH, IN, MO, IA, or NV, then I'm worried there might not be a plan available for you next year.
People should be worried about bare ACA counties in 2019 b/c of GOP sabotage.
Between mandate repeal, short-term plans, health ministries, farm bureaus, etc, the guaranteed $ for the lone ACA insurer is getting smaller. It's not the same calculus as it was in 2017 & 2018.
UPDATE 4/11/18: I posted this piece about a month ago; I don't have any specifics, but I have reason to believe that the Michigan state legislature could be moving on this any day now. If you live in Michigan, CALL YOUR STATE SENATOR OR REPRESNTATIVE AND TELL THEM *NOT* TO IMPOSE WORK REQUIREMENTS ON "HEALTHY MICHIGAN" ENROLLEES!
State Senate introduces bill to add work requirements to Medicaid
The bill would require able-bodied adults to work or be in school for 30 hours a week in order to receive Medicaid.
Some lawmakers in Lansing want people to work to get Medicaid. The Senate introduced a bill Thursday. It would add work requirements to the Medical Assistance Program, or Medicaid.
...If passed, able-bodied adults would be required to work or continue school for 30 hours per week as a condition of receiving medical assistance.
Alabama, which has refused to expand Medicaid for low-income adults under the Affordable Care Act (ACA), is now proposing to make work a condition of Medicaid eligibility for very low-income parents, stating that it wants to encourage work. Its proposal, however, actually would penalize work: because Alabama hasn’t expanded its program, those who comply with the new requirements by working more hours or finding a job will raise their income above the state’s stringent Medicaid income limits, thereby losing their Medicaid coverage and likely becoming uninsured.
Five weeks ago, when Idaho Governor "Butch" Otter announced that Idaho had decided to basically just blow off federal law altogether and start offering non-ACA compliant health insurance policies on the individual market alongside the compliant versions, I wrote:
To be honest, I'm not entirely sure I understand why Idaho would do this. Yes, of course the deep red state government opposes the ACA in general and sure, they want to "lower premiums" on the individual market, but Trump's recent "ShortAss Plan" executive order would do pretty much the same thing(allowing non-ACA compliant off-exchange "Short Term/Association Plans" which amount to the same thing...without putting GOP Gov. Butch Otter's fingerprints all over the ugly stories which would soon follow if/when people started actually enrolling in these types of policies. Besides, as much as Idaho claims to hate the ACA, they seem to be quite proud (and rightly so) of their own state-based ACA exchange, Your Health Idaho.
Well, it sounds like CMS Administrator Seema Verma was thinking along the same lines, because this unexpected story broke a few hours ago: Verma sent a letter to Otter and his state Insurance Commissioner shooting down their "state-based plans" idea as being flat-out illegal.
Top Republican looks to codify move to short-term healthcare plans
Sen. John Barrasso, R-Wyo., introduced legislation Wednesday that would let more people enroll in short-term health insurance plans, an idea that builds off a Trump administration proposal issued last month.
The Improving Choices in Health Care Coverage Act would allow people to stay on less expensive, short-term medical plans for as long as 364 days and allow them to renew for subsequent years.
Yes, that's right: "Improving Choices in Health Care Coverage Act", or ICHCCA. I'm going with #IckyJunkPlan instead, it rolls off the tongue better.
In other words, this would codify Donald Trump's executive order into federal law. It might even trump (no pun intended) state laws against #ShortAssPlans, although perhaps not.
Today, Covered California issued a new study about the projected impact of Donald Trump and Congressional Republican efforts to undermine and sabotage the Affordable Care Act not just in 2019, but over the next 3 years. They main focus is on two sabotage moves which have already happened (repeal of the individual mandate and the shortened/underfunded marketing of the open enrollment period on the federal exchange) and one which is on the verge of happening (Trump's "Short Term and Association Plan" executive order, aka #ShortAssPlans).
