Now That ACA Remains in Place Maybe We Should Keep An Eye On This Recent HHS Letter to Governors.

“……We are seeking to empower states with new opportunities that will strengthen their health insurance markets.”

Thomas E. Price, M.D., The Secretary of Health and Human Services (HHS), A Letter To Governors, dated March 13, 2017

On March 13, 2017, the Department of Health and Human Services (HHS) sent a letter to state governors to highlight Section 1332 of the Affordable Care Act (ACA). Beginning in 2017, Section 1332 allows states to apply for a State Innovation Waiver from certain ACA requirements.

With the lawmakers firmly stuck in the healthcare mud, one wonders if some states might start to make health insurance changes on their own. Under a little known provision of the Affordable Care Act (Section 1332) called the State Innovation Waiver, states have the ability to make changes by applying for waivers from certain major provisions of the law beginning this year (2017).  These waivers are intended to allow states the flexibility to pursue innovative strategies for providing their residents with access to high quality, affordable health insurance, while retaining some of the consumer protections of the ACA.

Examples of things that may be waived include:

• Establishment of qualified health plans (QHPs);
• Consumer choices and insurance competition through the Exchanges;
• Premium tax credits and cost-sharing reductions for plans offered within the Exchanges;
• The employer shared responsibility rules; and
• The individual mandate.

While this provision and Price’s recent letter on the subject seemingly flew under the radar, you have to wonder if we might start to see some states initiating their own changes to Obamacare. If this is going to happen, we’ll likely start hearing about it in the next few months.  Sometime this summer is when carriers submit rate increases or announce intentions to withdraw from the individual market all together.  Analysts are predicting both to happen.  It’s anticipated carriers will request huge rate increases — sticker shock on steroids — for individual plans on and off exchange.  And, more carriers are expected to be leaving the individual market.  Aetna and UnitedHealthcare are already out, and Bloomberg recently reported that Anthem (BlueCross and Blue Shield in 14 states) is leaning toward exiting in most if not all of its markets.

I doubt anyone really knows where all this is going, or where it will end up. Maybe some states will act, maybe not.

One thing that’s almost certain: Access to employer sponsored health plans will be more important than any time since Obamacare (ACA) became law.

Here’s a link to more info:  HHS Promotes ACA Section 1332 Waivers

It’s Official — Transitional Relief or “Keep Your Plan” for Small Groups Extended Through 2018

The Transitional Relief Provision has been extended as expected at least through December 31, 2018. We reported on it last week here. Small employers with non-ACA compliant or “grandmothered” plans will once again have the option to keep those plans in place until the end of 2018.  Carriers will be notifying policy holders about renewal options in the near future.  BBG clients please contact us anytime if you have any questions or need assistance.

Here is the official CMS release announcing the extension of the Transitional Relief/Keep Your Plan Provision.

UnitedHealthcare News Release Indicates Small Group Transitional Relief Plans (pre-ACA) Are Likely To Be Extended Beyond 2017

While we wait to see what happens with the New Trump Administration’s plans to repeal and replace………….

In a recent field communication pertaining to Small Group renewals, UnitedHealthcare (UHC) announced that they were making provisions for small employers with non-ACA compliant plans to have the option to keep those plans in place beyond 2017. This “Keep Your Plan” option from UHC is contingent upon the Transitional Relief provision being extended again as expected.  Our guess is that some of other carriers in the Small Group market will follow suit.

The Transitional Relief provision was first enacted when the ACA went into full effect in 2014. Often referred to as the “Keep Your Plan” provision, this provision was extended twice after it first went into effect.  Under the last extension all plans not compliant with ACA were set to expire 12/31/2017.

In January, the new Trump Administration issued a memo “to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the [ACA] that would impose a…cost…or regulatory burden on individuals, families, [or]…purchasers of health insurance.” UHC’s move indicates they expect the new Administration to issue another “Keep Your Plan” extension and that the expiration date will be postponed for at least another year (through 2018) and perhaps indefinitely.

UHC indicated that the Transitional Relief notice applies to: Arizona, Arkansas, Alabama, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, and Wisconsin.

We’ll be following closely and will keep our clients, especially those who currently have Transitional Relief Plans, posted.

For more info click on the links below:

Trump Administration Aims to Reduce Regulatory Burden

Previous Extension of Transition Policy for Non-ACA Compliant Health Plans Issued 2_29_16

ACA in 2017… Stay Tuned

What do we see?

Our opinion was that if Hillary Clinton had won, ACA would have gotten the heavy lift it would have needed to advance.  The difficult regulations would have been imposed (vs delayed further) and the money would have been allocated from general funds to stabilize the market.

Without the heavy lift, big trouble for ACA would be on the horizon.

The horizon is here.  What we see initially is that the regulations will start to go away (changed or ignored) and cash infusion will not happen.  What remains to be seen is what the party  in power will do to replace the law.  Doing nothing will almost be a replacement, but to what?  The Republicans do have various plans, but which course they will follow remains to be scene.

Our job will be to let you know how this will affect you and your people.  As of today, we just hold the course.  The taxes and reporting requirements are still in place. The plans on the market have not changed.  We will keep you aware as things change. If things hit your radar or you have questions on what you read or hear, please let us know and we will dig in.

For more on the latest:  ACA Compliance Bulletin — Congress Clears Path for ACA Repeal