In the Health Reform Update for this week, House Republicans pass controversial legislation to repeal and replace key provisions of the Affordable Care Act (ACA), while the Senate prepares to draft their own counterpart. The House bill would remove most of the ACA’s consumer protections, coverage expansion, and taxes, while allowing insurers to again vary premiums based on medical history for those with a lapse in coverage.
Although a Standard and Poor’s analysis shows that ACA Marketplaces are stabilizing, uncertainty created by the House bill, as well as the Administration’s “lack of clarity” on continuing the ACA’s cost-sharing subsidies and individual mandate, is causing proposed 2018 premiums in three states to increase by an average of 34 percent. Several insurers including Aetna decide to exit their ACA Marketplaces altogether for 2018. However, Blue Cross and Blue Shield of Tennessee agrees to enter 16 counties that were left with no Marketplace insurer after Humana’s departure earlier this year.
The Department of Health and Human Services praises Minnesota for becoming the second state after Alaska to create a reinsurance program to stabilize Marketplace premiums and encourages other states to do so.
Arkansas lawmakers agree to cut eligibility levels for its popular Medicaid expansion program and joins with Maine and Wisconsin in seeking federal approval to increase premiums and impose work requirements on expansion enrollees. Kansas lawmakers from both parties pledge to continue expansion efforts despite a gubernatorial veto while North Carolina Republicans introduce their first ever Medicaid expansion bill.