ACA Round-Up: Iowa, Massachusetts Waivers Stymied; States In CSR Case Face Tough Questioning

On October 23, 2017, Governor Kim Reynolds and Insurance Commissioner Doug Ommen announced that Iowa has withdrawn its 1332 state innovation waiver proposal. In a late afternoon press conference, Governor Reynolds and Commissioner Omen announced that the federal government had informed them that it would be several weeks yet before it could tell Iowa how much pass-through funding the state would receive to pay for its waiver program. With open enrollment just days away they could not proceed in the face of that uncertainty. Iowa therefore withdrew its request. Iowa had applied for a stopgap waiver in June under section 1332 when the insurers that had been covering Iowa’s individual market stated that they would not be returning for 2018, leaving it potentially with a statewide bare market. In the face of this, Iowa worked an arrangement with Wellmark, Iowa’s Blue Cross Blue Shield plan. Wellmark would provide coverage at premium rates negotiated with the state. Iowa would withdraw from the federally facilitated exchange and make its own eligibility determinations for premium credits. It would offer credits to all enrollees, including higher-income enrollees. Iowa insurers would offer only a single standard silver plan, which would have a high deductible but reasonably generous cost sharing for some services before the deductible attached. Iowa proposed to terminate cost-sharing reductions (CSRs) for low-income enrollees. It would use the pass-through payments of money the...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA 1332 waivers cost-sharing reduction payments Source Type: blogs