The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate.
The CMS cited the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House’s Office of Management and Budget to continue collecting data annually from exchange plans about their enrollees’ risk profiles.
In an earlier version of the request submitted to the executive branch last month, the agency estimated there were 2,400 issuers in the individual and small group markets.
. . .
The legislation’s future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached.
Murray and other Democrats, though, want significant changes to the bill, saying that it needs to be redone now that Republicans have destabilized health insurance markets by repealing ObamaCare’s individual mandate in the tax-reform bill last month.
. . .
In “Is Obamacare Harming Quality? (Part 1),” Michael Cannon explains that new research shows that Obamacare is not working how it is supposed to work in theory: The law’s preexisting conditions provisions create perverse incentives for insurers to reduce the quality of coverage; those provisions are reducing the quality of coverage relative to employer plans; and the erosion in quality is likely to accelerate in the future. In this post, he explains why regulators cannot fix this problem, and why providing sick patients secure access to quality health care requires allowing consumers to purchase health plans not subject to Obamacare’s preexisting conditions provisions.
. . .
Cannon offers new research showing that Obamacare’s preexisting condition provisions create perverse incentives for insurers to reduce the quality of coverage, reducing the quality of coverage relative to employer plans. The erosion in quality is likely to accelerate in the future. In a follow-up post, he explains why regulators cannot fix this problem and why providing sick patients secure access to quality health care requires allowing consumers to purchase health plans not subject to Obamacare’s preexisting conditions provisions.
. . .
Congress has no choice but to revisit the issue of health reform, and leaders have the greatest opportunity by tackling Medicaid. In 2016 the federal government spent $42 billion on ObamaCare’s exchanges. It spent $358 billion on Medicaid. States and localities pitched in another $208 billion, for a total national Medicaid expenditure of $566 billion in 2016. The growth in spending on health-care entitlements like Medicaid and Medicare threatens to overwhelm the Treasury, starving the federal government of the funds it needs to pay for everything else, including education, welfare and national defense.
. . .
U.S. House Ways and Means Committee Chairman Kevin Brady said on Thursday getting rid of the so-called “Cadillac” tax on high-cost employer-provided health insurance could be part of the spending deal now under negotiation in Congress.
“We want to get rid of it,” Brady, a Republican, told reporters outside his office, adding that this could “possibly” be part of an agreement lawmakers are seeking to avoid a government shutdown on Jan. 19.
“Even Democrats who put that awful tax in place, believe it needs to be delayed. If we can find some common ground there that would be terrific,” Brady said.
. . .
In a major policy shift that could affect millions of low-income people, the Trump administration said Thursday it is offering a path for states that want to seek work requirements on Medicaid recipients.
Seema Verma, head of the Centers for Medicare and Medicaid Services, said work and community involvement can make a positive difference in people’s lives and in their health.
The administration’s latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on “able-bodied” adults. Technically, those waivers would be “demonstration projects.” In practical terms, they would represent new requirements for beneficiaries in those states.
. . .
In a letter to President Trump, Leader McConnell, and Speaker Ryan, a dozen health policy leaders recommend that health reform continue to be a top priority in 2018. Insurance premiums continue to soar, and millions of people have little or no choice of health insurers. The group says individuals need to be empowered with greater flexibility and choice and that states are better equipped than Washington to oversee their health insurance markets. This requires legislative action from Congress to redirected resources and provide them with greater regulatory flexibility.
. . .
In a bid to expand access to affordable healthcare coverage, the Trump administration early Thursday rolled out proposed rules that would allow more small businesses and self-employed workers to band together to buy insurance.
The rule is part of the administration’s objective to encourage competition in the health insurance markets and lower the cost of coverage. But some experts say expanding access to these “association health plans,” which aren’t subject to many of the same regulations and consumer protections as other health plans sold under the Affordable Care Act, could weaken the individual health insurance market.
Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS). On March 14, 2017, the CMS sent a letter to state governors that signaled a willingness to use Section 1115 authority to support work requirements and the alignment of Medicaid programs with private insurance policies.
. . .