HHS Increases Reimbursements for ACA Reinsurance Program
The system -- called a reinsurance program -- requires insurers to pay into a pool that can be used to reimburse them if they incur claims that exceed a certain threshold. HHS said it will now reimburse 100% of such costs between $45,000 and $250,000, up from 80% previously.
HHS said it collected $8.7 billion from insurers for the program in 2014. That amount is predicted to increase by $1 billion by November. Through 2016, the program is projected to take in $25 billion (Ferris, The Hill, 6/17). According to CQ HealthBeat, HHS is increasing the reimbursements because CMS brought in more money for the program than it expects to pay back to insurers (Adams, CQ HealthBeat, 6/17).
According to The Hill, the announcement suggests the program is working and insurers have not faced the "pent-up demand" from ill customers anticipated by some observers (The Hill, 6/17).
Insurers applauded the expansion. Clare Krusing, a spokesperson for America's Health Insurance Plans, said, "This flexibility will ensure health plans can address the needs of enrollees managing multiple chronic conditions while making individual market premiums more affordable for consumers" (CQ HealthBeat, 6/17).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.