Hot on the heels of Wisconsin's ACA reinsurance program being approved by CMS comes another reinsurance waiver approval, this time for Maine:
The U.S Department of Health and Human Services and the U.S. Department of the Treasury (the Departments) approved Maine’s application for a State Innovation Waiver under section 1332 of the Patient Protection and Affordable Care Act (PPACA) (the waiver). Maine’s application seeks to reinstate a reinsurance program called the Maine Guaranteed Access Reinsurance Association (MGARA) from 2019 through 2023. As a result of the waiver approval, more consumers in Maine may have coverage, consumers will see lower premiums, and the state will receive Federal funds to cover a substantial portion of state costs for MGARA.
Maine’s State Innovation Waiver under section 1332 of the PPACA is approved subject to the state accepting the specific terms and conditions (STCs). This approval is effective for January 1, 2019 through December 31, 2023.
Summary of Maine’s State Innovation Waiver under section 1332 of the PPACA Application
One important twist: A few months back I remember reading that Maine, like several other states, was considering establishing some type of reinsurance program along the lines of successful programs in Alaska, Minnesota and Oregon. I also remember reading that the Maine version was unusual--it would actually involve reestablishing an old, discontinued state program which was still on the books but had been mothballed for years. However, I never got around to doing a write-up about it.
A state court in Maine has ruled that Gov. Paul LePage (R) must submit the paperwork necessary to move forward on expanding Medicaid under the Affordable Care Act to cover about 70,000 more low-income people in the state.
In her ruling, state judge Michaela Murphy slammed LePage’s health department for unilaterally blocking the expansion’s implementation since voters overwhelmingly approved it by ballot initiative last November.
“The Court concludes that the Commissioner’s complete failure to act cannot be considered substantial compliance,” she wrote, ordering the governor to submit the necessary paperwork to the federal government by June 11.
It wasn’t immediately known whether LePage planned to appeal the decision.
PREDICTION: Yeah, he will. He's out of office in seven months, and I'm willing to bet he's gonna continue doing everything possible to drag this out until his replacement takes office in January.
As noted earlier, I've been a bit lax with posting for a few days as I've worked on my latest 2-part video explainer about risk pools and #ShortAssPlans.
However, there's been a lot going on, so I figured I should try and at least do a quick update on a few items. First up: Medicaid expansion!
Here in my home state of Michigan, I've written several posts about how the GOP-controlled state legislature trying to shove through a draconian "work requirement" bill for Healthy Michigan, our name for ACA Medicaid expansion program which has been working just fine, thank you very much, for nearly 5 years now. The bill easily passed the state Senate (where the GOP holds a supermajority), and is now under consideration by the state House (where they have a smaller but still solid majority at the moment). The good news is that GOP Governor Rick Snyder--who championed passage of Healthy Michigan in the first place and seems to think it's fine mostly the way it is--is likely to veto the senate version of the bill. The bad news is that it might simply be tweaked somewhat by the House.
According to the CMS/ASPE 2016 Final Enrollment Report, during the 2016 Open Enrollment Period, Louisiana enrolled 214,148 people in exchange-based Qualified Health Plans.
Most states dropped a bit year over year in 2017 in large part due to the Trump administration cutting off outreach/marketing during the critical final week, but Louisiana saw the worst year over year drop. Why? Well, the most obvious reason was pretty simple: The state expanded Medicaid halfway through the year.
In the wake of a windstorm that knocked out power to more than 400,000 Mainers, federal officials have agreed to give Mainers more time to enroll for health care under the Affordable Care Act.
U.S. Sen. Angus King sent a letter to the Centers for Medicare and Medicaid Services in November requesting an extended deadline for Mainers who spent the better part of a week in the dark without internet or computer access. On Friday, King shared the agency’s reply, which said Mainers likely would qualify for a special enrollment period, extending their enrollment deadline.
“CMS recognizes that certain exceptional circumstances, including a natural disaster such as a severe windstorm, can prevent an individual from enrolling in coverage before an open enrollment period expires,” CMS Administrator Seema Verma said in her reply to King.
Maine voters on Tuesday decided to expand Medicaid to cover more low-income adults, becoming the first state to do so through a referendum.
Support for the ballot measure was up by more than 18 points with 64 percent of precincts reporting about 10 p.m. when it was called by NBC affiliate WCSH and The Associated Press.
The results in Maine, one of 19 states that rejected Medicaid expansion under the Affordable Care Act, comes as other Republican-led states like Utah and Idaho eye similar ballot measures.
Advocates of Medicaid expansion in Maine successfully petitioned the state to include a question on this year’s ballot following several failed legislative efforts to expand the program.
More to the point, however: What other significance does not including CSR funding have?
...That means that even if there's a last minute change to the bill, at this point, CSR payments are virtually certain not be guaranteed next year.
...I wouldn't be at all surprised to see more 11th-hour drop-outs next week. Donald Trump and the Republican Party's open sabotage of the ACA will likely bear even more fruit.
Anthem leaving Maine ACA marketplace, citing uncertainty
Anthem Blue Cross Blue Shield has withdrawn nearly all of its offerings from Maine’s Affordable Care Act health insurance marketplace, and the insurer is citing market uncertainty and volatility as the reasons.
The state of Maine's insurance regulatory agency has announced the approved 2018 individual market rate hikes for the three carriers operating in the state. Louise Norris beat me to the punch:
Regulators in Maine published rate proposals for the three Maine exchange insurers in June, and finalized the rates in early September. Insurers proposed two sets of rates: one that assumes cost-sharing reduction (CSR) funding will continue, and another that assumes the federal government will not fund CSRs in 2018.
The Maine Bureau of Insurance initially rejected all three insurers’ rate proposals on August 10, and asked them to submit new rates. The revised rate filings were then approved on September 1. These average approved rate increases all assume that CSR funding will continue in 2018:
