Policy Update-Wks of 2/9 & 2/16

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In the Health Reform Update for the past two weeks, Marketplace sign-ups for the second open enrollment period far exceed federal targets with more than 11 million consumers selecting private plans.  However, a surge of late applications forces all federal and state-based Marketplaces (SBMs) to extend the deadline past February 15th for those unable to complete the process.  The Centers for Medicare and Medicaid Services (CMS) and several SBMs also create a special enrollment period through April for those subject to the individual mandate under the Affordable Care Act (ACA).

Several state legislatures weigh measures to limit specialty tier coinsurance and prohibit discriminatory cost-sharing designs, as Avalere Health finds that Marketplace plans are increasingly relying on specialty tiers to control spending on high-cost conditions.  Medicaid expansion debates heat-up in Utah and Montana, despite the second defeat in neighboring Wyoming.  The new Pennsylvania governor starts the process of converting his state’s “private sector” expansion alternative to a traditional ACA expansion.

Standard and Poors warns that the success of non-profit health insurance cooperatives far outweighs their ability to pay medical claims after Congress rescinded remaining ACA funds, which will force most to be liquidated.

You can find the full Health Reform Update here. We also have more information our PSI Patient Coalition if you’re interested in Advocacy.



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