ACHP Media Monitoring Report – August 28, 2017

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Four steps to cut premiums, increase enrollment
A report from consulting firm Oliver Wyman outlines four steps that Congress could take to make insurance more affordable. According to the report, Congress should: commit to long-term funding for CSRs; create a reinsurance program; strongly enforce the individual mandate; and do away with the health insurance tax. The firm believes that by implementing this proposal, Congress could expand enrollment for two million Americans and reduce average premiums by more than 20 percent without increasing the deficit.

Insurers finally adjusting to ACA marketplace
Despite numerous setbacks including massive withdrawals and murkiness about the future of CSRs, health insurance experts believe the ACA is close to functioning as intended. Every county has at least once ACA health plan, ensuring that every American has access to coverage. Insurers have sharply narrowed their losses as they’ve adjusted to the individual market, and some are showing profits for the first time in 2017. Health plans have had to raise premiums higher than they expected, but many of the remaining insurers are adjusting to the market and finding the right equilibrium to remain profitable.

CHIP deadline nears
Funding for CHIP, which provides health care coverage to 9 million low and middle income children, expires in one month. Congress is debating several funding issues including the duration of the reauthorization, matching state funds and whether to include other measures or only focus on CHIP reauthorization. States are watching Congress closely as some may need to impose enrollment slowdowns or cancel policies altogether if Congress cannot pass reauthorization before the September 30 deadline.

Lobbying efforts underway on ACA taxes
Industry groups are ramping up efforts to repeal or delay the health insurance and medical device taxes, which are slated to take effect at the end of 2017. There is no clear legislative vehicle for Congress to take action at this time, even though there has been bipartisan support in the past to delay both taxes. The medical device tax does not cost a lot to address and is the only tax repealed in the bipartisan House Problem Solvers Caucus package of market reforms. However, the health insurance tax directly impacts premiums in all markets and is much more expensive to address. While repealing the health insurance tax could lower premiums by 2-3 percent, paying CSRs would keep premiums 20 percent lower.

CMS doubles down on Medicare Advantage vetting
CMS remains committed to implementing an audit program for Medicare Advantage plans that have not been reviewed in the past three years, despite claims from insurers that the proposal is unclear and inflexible. The plan is designed to ensure that Medicare Advantage plans have adequate provider networks. Under the program, plans that make major network changes and don’t inform CMS could face enforcement action. Insurers are concerned they could face financial penalties without additional guidance. CMS is giving 60 days’ notice before plans have to submit their networks to the database.