Tag Archives: reinsurance

ACA Round-Up: Mental Health And Substance Use Parity, Premium Tax Credits, And A New Marketplace Reinsurance Proposal

Continuing to implement mental health/substance use parity, three departments proposed a form for information on non-quantitative treatment limitations. The House passed three bills about premium tax credits. And Democratic senators proposed a reinsurance program to stabilize the individual market.

June 16, 2017

Iowa Submits 1332 Waiver Request, Claiming It Is Necessary To Avoid An Individual Insurance Market Collapse

On June 12, Iowa submitted a 1332 waiver request that would dramatically change the nature of its marketplace, claiming that this was needed to save a collapsing individual insurance market. To grant the request, CMS would have to waive many of 1332’s normal statutory and regulatory requirements.

June 12, 2017

CMS Checklist For State 1332 Waivers Focuses On High-Risk Pools, Reinsurance

On May 11, CMS and the Department of the Treasury released a checklist for state 1332 innovation waiver applications. Following up on HHS Secretary Price’s March 13 letter to governors, the checklist specifically focuses on state 1332 proposals to support high-risk pools or reinsurance programs.

May 12, 2017

Correcting Misconceptions About Invisible Risk-Sharing

An amendment to the AHCA draws in part from a proposal to include an invisible high-risk pool. Based on an independent analysis, there are a few misconceptions that should be corrected and changes that could improve the invisible risk-sharing program.

April 25, 2017

Making Sense Of ‘Invisible Risk Sharing’

Before Congress recessed last week, the House amended the pending American Health Care Act to include an “Invisible Risk-Sharing Program,” funded with $15 billion over nine years. What should we make of claims that this approach caused premiums to plummet in Maine and can make a big dent nationally?

April 12, 2017

The Marketplace Premiums Increase: Underwriting Cycle Or Death Spiral?

In this post, we aim to illuminate the underlying forces that led to dramatic increases in premiums so as to clarify the historical record and provide lessons for policymakers who aim to replace the ACA.

February 8, 2017

A Friendly Competition To Increase ACA Marketplace Stability: Calling All Actuaries

Without a doubt, the next administration and Congress will face difficult decisions about how best to address the challenges facing the individual health insurance market. The Robert Wood Johnson Foundation is sponsoring a competition for teams of actuaries to develop solutions to improve that...

October 11, 2016

Judge Rules In ACA Premium Stabilization Program Case; New Hardship Exemption

On August 12, federal judge Rebecca Ebinger entered the first decision in one of the growing number of cases challenging the administration of the premium stabilization programs, denying a motion for a preliminary injunction. CMS also announced a new hardship exemption to the individual mandate.

August 15, 2016

Struggling To Stabilize: 3Rs Litigation And The Future Of The ACA Exchanges

One day, ACA Marketplace plans may cover many of the 11 percent of Americans who remain uninsured. But the three programs---reinsurance, risk corridors, and risk adjustment---that the ACA’s drafters hoped would help stabilize premiums in the revamped markets have not performed as expected.

August 1, 2016

CMS Expects To Reinsure 55.1 Percent Of Claims Between $45,000 And $250,000

On June 17, 2016, CMS announced that it is anticipating that available funds will allow it to reinsure insurers at a rate of 55.1 percent for enrollee claims exceeding $45,000, up to a cap of $250,000.

June 20, 2016