Allow states the option of merging the individual and small group markets. (Effective January 1, 2014)
Create a temporary reinsurance program to collect payments from health insurers in the individual and group markets to provide payments to plans in the individual market that cover high-risk individuals.
Require qualified health plans to meet new operating standards and reporting requirements.
Provide refundable and advanceable premium credits and cost sharing subsidies to eligible individuals and families with incomes between 133-400% FPL to purchase insurance through the Exchanges.
Reduce the out-of-pocket amount that qualifies an enrollee for catastrophic coverage in Medicare Part D (effective through 2019).
The Independent Payment Advisory Board, unaccountable to Congress, will be empowered to set reimbursement rates for government health programs.
Reduce Medicare Disproportionate Share Hospital (DSH) payments initially by 75% and subsequently increase payments based on the percent of the population uninsured and the amount of uncompensated care provided.
Require Medicare Advantage plans to have medical loss ratios no lower than 85%.
Expand Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% FPL based on modified adjusted gross income (MAGI) and provides enhanced federal matching for new eligibles.
Reduce states’ Medicaid Disproportionate Share Hospital (DSH) allotments.