In the Health Reform Update for this week, Anthem Blue Cross Blue Shield and CIGNA become the latest major insurers threatening to scale back their participation in Affordable Care Act (ACA) Marketplaces unless regulatory changes ensure more favorable risk pools. The Centers for Medicare and Medicaid Services (CMS) hints that it may limit third-party premium assistance from charitable groups like PSI in order to address insurer complaints that making Marketplace plans affordable to high-cost patients is unfair to participating carriers.
A private analysis of Marketplace premiums shows that consumers in states resisting ACA implementation will pay 12 percent more on average in 2017 than those in states that expanded Medicaid and/or created their own Marketplace.
New Jersey seeks to become the latest state to protect consumers from surprise medical bills while new fiscal numbers in Louisiana show that the Medicaid expansion has turned a budget deficit into a surplus. A ballot referendum that would limit prescription drug prices for state health programs in California to those paid by the federal Department of Veterans Affairs appears to be in trouble after some consumer groups join the opposition from pharmaceutical companies.