The Congressional Budget Office (CBO) released an evaluation of the AHCA, portions of which were marked up by the U.S. House Energy and Commerce and the Ways and Means committees in early March. CBO estimates the legislation could have resulted in the loss of health insurance for 24 million Americans by 2026, while reducing the federal deficit by $337 billion over the same period. The Academy’s Individual and Small Group Markets Committee and Medicaid Subcommittee’s comments on the AHCA, sent to House leaders on March 22, address various approaches to federal Medicaid funding and the individual health insurance market.
The New York state Superintendent of Financial Services signed an emergency rule to establish a market stabilization pool for the individual and small group health insurance markets for the 2017 plan year.
The Centers for Medicare & Medicaid Services (CMS) undertook several administrative actions and released key documents in the past month, including:
CMS Administrator Seema Verma’s March 14 letter to the nation’s governors expressing support for states that wish “to design programs that meet the spectrum of diverse needs of their Medicaid population.”
A final rule on disproportionate share hospital dollars, stating that the hospital-specific limit calculation will be limited to costs incurred by Medicaid-eligible individuals who are not covered by Medicare or other third-party payers. The rule will take effect June 2.
A Unified Rate Review Template v4.1. (Excel spreadsheet; search “URR Template v4.1” on CMS’s website.)
The payment rate for insurers offering Medicare Advantage Plans, which is expected to rise by an average of 0.45 percent for 2018.
2018 Unified Rate Review Instructions for insurers selling non-grandfathered health insurance coverage in single-risk-pool markets.
The U.S. House of Representatives passed H.R. 1101, the Small Business Health Fairness Act, by a vote of 236-175. The bill would allow small employers to enroll in multistate association health plans as an alternative to fully insured small-group plans regulated by their home states.
The House passed H.R. 372, the Competitive Health Insurance Reform Act of 2017, by a 416-7 vote. The bill would end the antitrust immunity granted to health insurance companies by amending the McCarran-Ferguson Act of 1945.
The House passed H.R. 1304, the Self-Insurance Protection Act, by a 400-16 vote. The bill would exclude medical stop-loss self-insurance health programs from being defined as traditional health insurance.
The U.S. House Republican majority withdrew the AHCA from floor consideration after failing to gather enough support for the measure. The House Rules Committee approved an amendment to the AHCA on April 6 to allocate $15 billion for health plans to cover the cost of high-risk enrollees in the individual health insurance marketplaces; funding would be available from Jan. 1, 2018, through Dec. 31, 2026. No floor vote has been scheduled.
The Minnesota legislature passed the Minnesota Premium Security Plan, a bill designed to support the individual health insurance market with a state-based reinsurance program for plan years 2018 and 2019. The bill became law on April 3 after Gov. Mark Dayton stated he would let it become law without his signature.
On April 5, the Kansas legislature voted not to override Gov. Sam Brownback’s veto of H.B. 2044, a measure that would have expanded Medicaid coverage to low-income residents. Several other states have recently introduced bills to expand or revise Medicaid eligibility requirements.