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States weigh options amidst CSR uncertainty
Uncertainty over the future of CSR subsidies has forced state insurance commissioners to consider alternative strategies for stabilizing the market. If CSRs are not funded, states may allow insurers to apply a surcharge to premiums in order to cover the cost, although there are differing opinions on how those surcharges would be applied. Some states are considering allowing states to spread the cost across all their plans, including non-exchange plans. Others want insurers to load the cost onto silver-level plans, under the belief that increased consumer costs would be offset by federal subsidies.
Anthem exits ACA markets
Anthem has announced that it will stop selling ACA plans in about half of Georgia’s counties and Nevada’s state exchange next year. The Georgia counties where Anthem will continue to sell plans are mostly rural areas that would have otherwise been left without coverage. The decision to exit the markets was in part in response to uncertainty around CSR payments.
Price’s hopes for reshaping HHS
With input from HHS staff, Secretary Tom Price has a compiled a list of goals designed to steer the department in a new direction. Price’s goals focus on empowering market forces and individual choice, implementing data more effectively and streamlining department processes.
Medicare Advantage costs
The government pays more to Medicare Advantage insurers than plans pay out for patient care, and despite costing taxpayers more than traditional Medicare, Medicare Advantage plans spend less on care, according to a study based on billing data. One reason for the lower spending is that Medicare Advantage beneficiaries tend to use less of certain types of costly care than Medicare beneficiaries, including hospital care and visits to specialists. Medicare Advantage plans also draw enrollees who are typically healthier than traditional Medicare beneficiaries. The higher payments to insurers come from the design of the program, which was meant to benefit the private market and compensate for administrative and marketing expenses.
Maine requests Medicaid waiver
Maine submitted a Medicaid waiver to encourage personal responsibility for health care costs. The waiver includes work requirements, mandatory premiums and asset testing. If the waiver is approved, Maine would have one of the most conservative Medicaid programs in the country, and experts caution some low-income adults could be pushed out of the program.