In the Health Reform Update for the past two weeks, Senate leaders roll out their changes to the House-passed bill that would repeal and replace key provisions of the Affordable Care Act (ACA). However, protests from conservative and moderate Republicans may impede their plan to amend and vote on the bill next week.
The Senate’s Better Care Reconciliation Act (BCRA) restructures ACA tax credits and delays the phase-out of the Medicaid expansion while increasing long-term cuts to Medicaid. It fully-funds the ACA cost-sharing subsidies before repealing them in 2019 and removes the controversial provision that would let states once again allow persons with pre-existing conditions to be charged higher premiums.
Anthem announces that it will exit two additional ACA Marketplaces (in Indiana and Wisconsin). However, Aetna backtracks on their pledge to sit-out off all Marketplaces for 2018 while a new start-up enters into several new regions where Marketplace insurers have departed.
Marketplace insurers continue to seek premium increases of up to 80 percent to compensate for the potential loss of ACA cost-sharing subsidies and the individual mandate. A consultant estimates that up to two-thirds of 2018 increases can be blamed on those two factors.
The Nevada governor vetoes legislation that would have given all state residents the opportunity to purchase Medicaid-equivalent coverage through the ACA Marketplace.