New Guidelines Would Grant States Flexibility To Use Health Law Subsidies On Plans That Don’t Meet ACA’s Requirements
Under the examples outlined by CMS Administrator Seema Verma, a state could create an entirely new subsidy program, basing aid on age, rather than income, or set income limits higher or lower than the federal requirements. But uncertainty about the validity of the guidance may mean few states will be interested in the new flexibility offered by CMS, because any state looking to implement the ideas could be sued even if the CMS approved its 1332 waiver.
The Washington Post:
New Insurance Guidelines Would Undermine Rules Of The Affordable Care Act
According to advice issued Thursday by federal health officials, states should be free to redefine the use of those subsidies, which began in 2014. They represent the first help the government ever has offered middle-class consumers to afford monthly premiums for private insurance. States could allow the subsidies to be used for health plans the administration has been promoting outside the ACA marketplaces that are less expensive because they provide skimpier benefits and fewer consumer protections. In an even more dramatic change, states could let residents with employer-based coverage set up accounts in which they mingle the federal subsidies with health-care funds from their job or personal tax-deferred savings funds to use for premiums or other medical expenses. (Goldstein, 11/29)
Bloomberg:
Trump To Let States Divert Obamacare Funds To Other Health Plans
“For far too long, states have looked to Washington with a ‘Mother, may I?’ approach,” said Seema Verma, the administrator for the Centers for Medicare and Medicaid Services. “Today we are saying the states have the power to make the individual markets work through innovative policies that best meet the needs of your citizens.” (Tozzi, 11/29)
The New York Times:
Federal Subsidies Could Expand To Health Programs That Violate Obamacare
The Trump administration said Thursday that states could bypass major requirements of the Affordable Care Act by using federal funds for a wide range of health insurance programs that do not comply with the law. Federal officials encouraged states to seek waivers from provisions of the law that specify who is eligible for premium subsidies, how much they get and what medical benefits they receive. (Pear and Goodnough, 11/29)
Modern Healthcare:
CMS Allows States To Get Creative With Federal Exchange Funds Under 1332 Waivers
States can use 1332 waivers to launch new financing options that resemble health savings accounts, according to CMS Administrator Seema Verma. But a former agency official warns that using any of the new flexibilities outlined could result in litigation. This new account-based program would help subsidize healthcare expenses. Under this approach, states would provide a cash contribution to an account that people can use to pay both premiums and any out-of-pocket health expenses. (Dickson, 11/29)
The Wall Street Journal:
Trump Administration Details Health-Law Waivers For States
“The specific examples laid out today show how state governments can work with HHS to create more choices and greater flexibility in their health insurance markets, helping to bring down costs and expand access to care,” said Health and Human Services Secretary Alex Azar. The flexibility being offered to states marks a fundamental shift in approach, health analysts say. The Obama administration sought to make sure people had a minimum level of coverage, while the waivers show the focus now is on making sure people have access to some kind of coverage. (Armour, 11/29)
Kaiser Health News:
Is Trump Pushing Health Insurance Innovation Or An ACA Rollback?
Policy experts predict the ideas would further foster a parallel market of cheaper, less robust coverage that could draw younger or healthier consumers, but drive up premiums for those who remain in ACA market plans. “Invariably, the coverage is going to be more expensive for people who really need comprehensive coverage,” said Timothy Jost, a retired Washington and Lee University law professor who follows the ACA closely. (Appleby, 11/29)