Topic: Health Insurance Exchanges

The 2019 Final Notice of Benefit & Payment Parameters

Jessica Smith

The Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters (NBPP) for 2019 final rule was released on April 9, 2018. It has been a rocky road since the beginning for the Affordable Care Act (ACA). Over the past few years, the healthcare industry has been struggling to find balance in order to provide affordable healthcare for all. Many issuers have opted not to offer Qualified Health Plans (QHPs) in order to avoid negative financial repercussions due to market unpredictability. At its highest, there were 252 issuers participating on the Federally-Facilitated Marketplace (FFM) in 2015. This year, that number has decreased to 132 issuers.

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Work Requirements in Medicaid: The True Costs

Thomas Johnson

Many states are looking to add work requirements for their Medicaid recipients. The “fever” that has spread with various governors and state legislators has translated into 20 states in some form or another considering work requirements, either through the waiver process or through legislation. Some states are dealing with this question through their budget process, and some states are attempting to couple Medicaid expansion with work requirements.

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Trump Administration Rolls out Proposal for Association Health Plans

Olga Walther

The Department of Labor (DOL) released a proposed rule making changes to Association Health Plans (AHPs) as directed by President Trump’s Executive Order. Specifically, DOL proposes to make changes to the definition of “employer” in order to expand AHP offerings to consumers. The notice of proposed rulemaking will be published in the Federal Register on January 5, 2018, and be available for public comment for 60 days.

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The Outlook for Government-Sponsored Health Programs in 2018

John Gorman

As 2018 and Year 2 of the chaotic Trump Administration kick off, trying to predict what will happen in Medicare, Medicaid, and the Affordable Care Act is as challenging as ever. It’s a midterm election year with terrible headwinds for the GOP, so the legislative calendar is abbreviated, and partisan rancor will peak. That makes it less likely Republicans will get to do much damage but also more likely they will try to serve up red meat for their base, like a return to “repeal and replace.” Congressional leaders, fresh off their billionaire bailout tax bill, are already talking about taking up “reform” (aka cuts) of Medicare and Medicaid and other social welfare programs. The only thing that is certain is 2018 will be another battleground year for government health programs.

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The 2019 Proposed Notice of Benefit and Payment Parameters

Jessica Smith

The annual Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameter (NBPP) for 2019 proposed rule was released on October 27, 2017. It contains some eye-opening details about the future path of the Affordable Care Act (ACA). There have been many attempts this year to dismantle and drastically alter the course the ACA set out to achieve. The 2019 NBPP proposed regulations display the same message that has been heard all year – to make many changes to the foundational structure and administration process of the ACA.

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Will We See a Resolution to Cost Sharing Subsidy Payments and does it Matter

Olga Walther

With two months of Affordable Care Act (ACA) stabilization bill efforts under the belt, it is becoming questionable whether Congress will be able to pass, or even bring to the floor, a bill President Trump will support and sign. We saw some developments this week that may shape the future of cost sharing subsidy payments as well as any other ACA fixes in the months to come.

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Is Obamacare Repeal Dead? Not So Fast…

Thomas Johnson

Many thought, with the failure of the U.S. Congress to repeal the Affordable Care Act (ACA) at the end of the 2017 fiscal year, the act was safe from another repeal effort under this Congress. While the names in the Senate may remain the same, the effective plan may have now changed. Former Centers for Medicare & Medicaid Services (CMS) Administrator Andy Slavitt has described this as “synthetic repeal.”

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