In the Health Reform Update for this week, Congress postpones the first vote on dismantling the Affordable Care Act (ACA) until at least March as concerns mount over insurer defections. The Trump Administration prepares a package of new rules to stabilize the Marketplaces until Congress can agree on a series of piecemeal measures that would replace or repair key provisions of the ACA.
A White House directive eliminating Marketplace advertising and outreach for federally-facilitated Marketplaces is blamed for a lack of late sign-ups during the last two weeks of 2017 open enrollment. Despite the typical surge of last-minute enrollees in state-based Marketplaces, total enrollment is expected to be below the prior year’s total for the first time since the Marketplaces opened. The Congressional Budget Office predicts that Marketplace enrollment will recover and remain steady if the ACA remains intact.
Avalere Health confirms that Marketplace consumers are paying more for less in 2017. Minnesota enacts a temporary premium relief program to provide state rebates to those ineligible for ACA subsidies. California withdraws its effort to expand Marketplace coverage to undocumented residents.
Republican governors continue to push Congress and the Administration to leave the Medicaid expansion and other key provisions of the ACA intact. Governor Baker (R) in Massachusetts seeks to replace the never-implemented employer mandate in the ACA with a more severe penalty.