ACA Round-Up: CMS Approves Alaska 1332 Reinsurance Waiver, Ceases Premium Outlier Reviews

On July 11, 2017, the Centers for Medicare and Medicaid Services announced that the Departments of Health and Human Services and Treasury have approved Alaska’s application for a 1332 state innovation waiver for its reinsurance program. (fact sheet). The approval was no surprise. It had been pending since December of last year and has received very broad support. The HHS Secretary sent a letter to state governors in March encouraging similar waiver applications and HHS issued a checklist in May to assist states in applying for 1332 waivers which encouraged reinsurance waivers. The program will be administered by the state and by the Alaska Comprehensive Health Insurance Association (ACHIA). Alaska will reinsure insurers for individuals with one or more of 33 high-cost conditions. Insurers will cede to the reinsurance program both premiums received for individuals with these conditions and claims they would have paid had the individuals remained enrolled with the insurer. Insurers and the ACHIA are responsible for truing up any risk adjustment payments received by or owed by covered insurers under the federal risk adjustment program to avoid duplicate federal payments from the two programs. It is expected that because of the program premiums will be 20 percent lower in 2018 than they would otherwise be, and that 1,460 additional individuals will gain coverage. The program is expected to reduce the cost of the benchmark silver plan, and the federal government will pass throug...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage 1332 waivers Alaska Marketplace premiums reinsurance risk corridor payments Source Type: blogs