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

Perhaps the most immediate problem facing federal and state health policymakers—and consumers—is what can be done for marketplace consumers in “bare counties” for 2018. As of early June, 2017, there are 47 counties in Ohio, Missouri, Kansas, and Washington where there are currently no insurers offering to provide marketplace coverage for 2018. Approximately 38,000 Affordable Care Act marketplace enrollees live in these counties (only 0.3 percent of the total), but under current law they have no access to the ACA’s premium tax credits and cost-sharing reduction payments that make health care affordable for lower-income Americans. At least two bills have been introduced into Congress to provide access to coverage for these consumers. One bill, introduced by Senators Alexander and Corker (both Tennessee Republicans) would offer tax credits to purchase coverage outside of the marketplaces—not with advanceable tax credits but rather with tax credits that would be payable at tax filing time, probably too late for many ACA enrollees. A second bill, introduced by Missouri Democrat Sen. Claire McCaskill, would allow consumers in bare counties to receive premium tax credits and enroll in coverage through the District of Columbia small business exchange. Neither bill has been taken up by Congress. It is also possible that a state could take action to address the bare county problem through an innovation waiver under section 1332 of the ACA. Section 1332 allows the Depart...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage bare counties 1332 waivers advance premium tax credits cost-sharing reduction payments high-risk pools reinsurance Source Type: blogs