A coalition of policy experts from conservative think tanks and advocacy groups is quietly working to spur Congress to take another shot at overhauling Obamacare before the midterm elections.
The group, which includes former Sen. Rick Santorum (R-Pa.), has members from the American Enterprise Institute, the Heritage Foundation, and the Goldwater Institute who have met weekly since Republicans last gave up on trying to repeal the Affordable Care Act. They have met with Republican congressional aides and White House staff to discuss their ideas for turning the health law into a block grant program meant to give states far more control over health insurance regulations.
. . .
People will be able to enroll in Obamacare plans directly through web brokers and health insurers for 2018, which will reduce the need for federal outreach funds.
That feature will likely be included in an upcoming Department of Health and Human Services proposed rule under review at the Office of Management and Budget, Joel White, president of the Council for Affordable Health Coverage (CAHC), told Bloomberg BNA Sept. 22. Congress isn’t likely to provide more funding for Affordable Care Act outreach activities, so “HHS is going to have to figure out ways to expand options for consumers to get enrolled,” White said HHS officials have told his group. The CAHC is a broad-based group of health-care industries.
. . .
The Trump administration is examining whether it’s legally permissible to keep funding Obamacare subsidies for low-income people, but “there’s a desire” to include them in the Republican health-care bill, a top White House health-care adviser told Bloomberg BNA.
The individual market won’t be stable unless Congress passes the Republicans’ American Health Care Act, Brian Blase, special assistant to the president in the National Economic Council, said in a May 12 interview with Bloomberg BNA. Anthem Inc., a major carrier in the Affordable Care Act exchanges, told White House officials that large premium increases it has requested for 2018 are based on the assumption that the cost-sharing reduction (CSR) subsidies will be paid, Blase said.
. . .
Small businesses have been pumping the brakes on offering health benefits to their employees since 2009, according to new data from the Employee Benefit Research Institute.
“The fact is that small employers were less likely to offer these benefits to begin with,” Paul Fronstin, EBRI’s director of health research and education program and author of the report, told Bloomberg BNA July 28. “While the ACA was designed to try to get more small employers to” offer health insurance, “it hasn’t.”
The proportion of employers offering health benefits fell between 2008 and 2015 for all three categories of small employer, EBRI found: by 36 percent for those with fewer than 10 employees, by 26 percent for those with 10 to 24 workers and by 10 percent for those with 25 to 99 workers.
. . .
Opt-out payments offered by employers may be used to determine affordability under the Affordable Care Act, depending on whether they are conditional or unconditional, according to IRS proposed rules.
Under the proposed rules, opt-out payments, cash payments given to employees who opt-out of their employer-sponsored health insurance, will be treated as a salary reduction for the purposes of determining health insurance affordability if they are considered unconditional.
An unconditional opt-out payment refers to an arrangement where the employee declines employer-sponsored health insurance without satisfying any other requirements.
. . .
The goal of all insurance plans is to provide the right services to the right patient population. Insurance eligibility is a big factor, and companies spend a lot of time and effort determining if their patients qualify for coverage. The question of eligibility is also critical to the operation of the Affordable Care Act’s insurance marketplaces, and a recent OIG report found problems within the New York state marketplace that potentially led to ineligible enrollees.