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Archive: Health Insurance Exchanges

Capitol Connector
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

Leaked Memo Details Trump Administration’s ACA Plans

January 18, 2018 | ACA | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

A Trump Administration memo detailing plans to dismantle provisions of the Affordable Care Act (ACA) through executive action was made public last week. Released by Senate Democrats, the one-page document lists ten possible points of action to follow up on the President’s 2017 Executive Order to reduce the “economic burden” of the ACA. A number of the initiatives have already been enacted, while others, including weakening the essential health benefits requirement, are currently being considered.

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Trump Administration Aims to Expand Association and Short-Term Health Plans

January 11, 2018 | ACA | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Last week, the Trump Administration proposed new rules that would allow small businesses and trade groups to band together to purchase health insurance. This move would open the door to limited coverage health plans, including plans that lack mental health and substance use disorder benefits. The proposed rules come from an executive order President Trump signed earlier this year that directed federal agencies to loosen restrictions on short-term health insurance and association plans to create less comprehensive coverage options.

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National Council Opposes Proposal to Weaken Essential Health Benefits

November 30, 2017 | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Monday, the National Council submitted comments to the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) regarding proposed changes to the Essential Health Benefits (EHB) for marketplace insurance plans. The proposed changes would allow states to choose less comprehensive coverage for mental health and substance use services, which would hurt patient care and raise their out-of-pocket costs. The National Council expressed strong opposition to this proposal and other EHB changes in addition to reiterating support for including prescription drug utilization in the Risk Adjustment Model.

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CMS Proposes Insurance Marketplace Rules for 2019

November 9, 2017 | Health Insurance Exchanges | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Last month, the Centers for Medicare and Medicaid Services proposed new marketplace rules for the 2019 open enrollment period. The rule reflects an executive order signed by President Trump earlier in his administration to roll back regulatory requirements on insurance agencies and states. Of importance, the rules would allow for states to tinker with the essential health benefits benchmark every year.

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Congressional Efforts to Stabilize ACA Markets Continue

October 26, 2017 | Health Insurance Exchanges | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Legislators have continued efforts to approve legislation that would aim to stabilize the individual insurance marketplaces for FY2018. Following months of bipartisan negotiations, Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) continue gaining support for their approach to the issue. As of last week, more than two dozen Senators had signed on as cosponsors. This week, though, a second proposal has been introduced, this time by Chairman of the Senate Finance Committee Orrin Hatch (R-UT) and Chairman of the House Ways and Means Committee Kevin Brady (R-TX).

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New Bipartisan Health Plan Would Keep ACA Subsidies

October 19, 2017 | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Tuesday, Senate Health, Education, Labor and Pensions (HELP) Committee leaders Lamar Alexander (R-TN) and Patty Murray (D-WA) unveiled a bipartisan proposal to stabilize the individual insurance market through 2019. The deal follows President Trump’s announcement that his administration would no longer make cost-sharing reduction (CSR) payments to insurers. The Alexander-Murry plan would restore this funding and bring market-based reforms and new flexibility to the states. The future of this bill is uncertain in wake of conflicting comments from President Trump and negative reaction from some members of the House of Representatives.

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Trump Signs Executive Order Setting Path to Expand Association Health Plans

October 12, 2017 | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Thursday, President Trump signed an executive order (EO) to broaden availability of Association Health Plans (AHPs) and short-term health insurance policies. These health plans would be largely exempt from Affordable Care Act’s (ACA) coverage requirements and are seen as a potential threat to the stability of the health care marketplaces. President Trump has said the move will bring greater competition and lower premiums to insurance markets across the country.

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Senate Committee Completes Bipartisan Hearings on Health Care

September 21, 2017 | Health Insurance Exchanges | Comments

Malka Berro

Behavioral Health Policy and Practice Intern

Last Thursday, the Senate Health, Education, Labor and Pensions (HELP) Committee held its final bipartisan hearing on efforts to stabilize the individual health insurance market. The committee heard testimony from provider, state and insurer stakeholders on stabilizing premiums and helping people in the individual insurance market. Despite these efforts, it was announced this week by Committee Chairman Alexander that bipartisan efforts had stalled and no further negotiations would take place.

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Governors Send Letter to Congressional Leadership Recommending Health Insurance Reform

September 7, 2017 | Health Insurance Exchanges | Comments

Malka Berro

Behavioral Health Policy and Practice Intern

Late last month, Governors John Hickenlooper (D-CO) and John Kasich (R-OH) led a bipartisan letter to Senate and House leadership recommending changes to improve affordability and restore stability to the individual health insurance market. Additional signers included Governors from Nevada, Pennsylvania, Alaska, Virginia, Louisiana, and Montana. The letter specifically noted the importance of ensuring access to care for those with mental illness and addiction.

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Cutting ACA Subsidies Would Hike Premiums by 20 Percent, CBO says

August 17, 2017 | ACA | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

A new Congressional Budget Office (CBO) report estimates a 20 percent increase in health insurance premiums for low income individuals who purchase insurance through an exchange should the Trump Administration end cost-sharing reduction (CSR) subsidies. The CBO report, projecting the effects of ending these ACA payments, comes after months of President Trump threatening to end the CSR payments to insurers. The Administration has made the payments for August and is currently deciding whether make them again in September.

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ACA Exchanges Expanding, Future Still Uncertain

August 10, 2017 | Health Insurance Exchanges | Comments

Shelley Starkey

Project Assistant

Some insurance companies are stepping in to fill the void of health plans in multiple counties with bare health insurance exchanges across the country. While this bodes well for the stability of exchanges in the short-term, the long-term stability of the individual and small group market is uncertain under the Trump Administration’s repeated threats to discontinue important cost-sharing reduction (CSR) payments. Meanwhile, some members of Congress are trying to ensure that these subsidies continue regardless of the President’s actions.

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Lawmakers Consider Options on Health Care After “Skinny” Repeal Failure

August 3, 2017 | ACA | Health Insurance Exchanges | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Amid last week’s failed Senate health care vote, members of Congress continued to weigh potential paths forward on the repeal of the Affordable Care Act (ACA). While it remains unclear exactly what shape the next health reform proposal will take, there appears to be bipartisan support for a measure that addresses stabilizing the individual insurance market in the immediate future. Neither chamber is expected to vote on any major health care measure before September.

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Health Experts Agree: Insurance “Across State Lines” Still Possible

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

As health care debate and reform continues on Capitol Hill, one long-term conservative goal that still remains is the prospect of selling insurance across state lines. Such a development could be potentially disastrous for addiction and mental health providers across the country as experts fear plans would kick-off a “race to the bottom” and sell insurance from states with fewer mandates and regulations. As the Senate continues deliberations on health reform legislation, it is imperative advocates stay informed and engaged to prevent these devastating policy changes.

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Budget, ACA Subsidies Take Center Stage as Congress Returns from Recess

April 20, 2017 | ACA | Health Insurance Exchanges | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

When Congress returns from recess on Monday, it will have just one week to finalize a budget deal keeping the government open for the remainder of the 2017 fiscal year. President Trump’s budget request for this year calls for cuts of more than $50 billion dollars to pay for an increase in military spending. While these negotiations continue, health insurers are working with the Administration to secure more than $7 billion in cost-sharing subsidies through the Affordable Care Act. It remains to be seen how these decisions will impact major health care reform legislation.

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House GOP Releases Plan to Repeal and Replace the ACA

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Wednesday, Speaker of the House Paul Ryan (R-WI) and other House GOP leaders unveiled their alternative to President Obama’s signature health care law, the Affordable Care Act (ACA). While the plan does not include a number of specific details including the overall cost and total number of covered individuals, it does present a broad outline of a potential GOP health reform agenda for the next administration. As in the past, this initiative includes a number of proposals that would directly repeal ACA provisions as well as revamp current practices in Medicare, Medicaid and marketplace health care coverage.

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HHS Finalizes Wide-Ranging ACA Nondiscrimination Rule

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Wednesday, the Department of Health and Human Services’ Office of Civil Rights (HHS OCR) issued its final rule on nondiscrimination in federal health care programs and activities. The final rule prohibits discrimination based on race, color, national origin, age, disability and sex in all health programs and activities, any part of which receives federal financial assistance administered by HHS. The rule takes effect on July 18, 2016.

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CMS Issues Guidance on Little-known State-ACA Waivers

December 17, 2015 | Health Insurance Exchanges | Medicaid | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Beginning in 2017, states will have an avenue by which to fundamentally alter their methods for offering and regulating public health insurance. Section 1332 “State Innovation Waivers” were included in the Patient Protection and Affordable Care Act (ACA) to allow states the opportunity to pursue innovative methods of providing access to affordable, high quality health care while still maintaining the key elements of the ACA. However, there is growing concern over the potential scope of these waivers and their ability to significantly modify how states offer affordable insurance coverage through the marketplace.

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Senate Approves ACA Reconciliation Bill, Repealing Medicaid Expansion

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Last week, the Senate approved a highly partisan budget reconciliation bill that repealed a significant portion of the Affordable Care Act, including Medicaid expansion. The bill also repealed the authority of the federal government to run health care exchanges and eliminated subsidies to help people afford plans purchased through those exchanges. Passed on party lines, the bill now must pass the House before heading to the President’s desk. The White House has made clear the President intends to veto the legislation, protecting his signature legislative achievement.

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CMS Finds Qualified Health Plans, CHIP too Different to Certify as Comparable

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

A new analysis from the Centers for Medicare and Medicaid Services finds that coverage through the Children’s Health Insurance Program (CHIP) is more comprehensive and more favorable for kids and families than marketplace exchange plans. The comparison, mandated by the Affordable Care Act, concluded that CHIP plans are more likely to meet the needs of kids and families and therefore could not certify the plans as comparable.

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CMS Finalizes Essential Health Benefits Benchmark for 2017

November 12, 2015 | Health Insurance Exchanges | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

This week, the Centers for Medicare and Medicaid Services (CMS) finalized Essential Health Benefits benchmark plans for 2017. The essential health benefits are the minimum coverage floor for health plans sold on the state and federal marketplaces, as well as Medicaid expansion plans. While each state determines its own essential benefits, all plans must include 10 categories of coverage – including mental health and substance use.

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