Manatt on Health Reform: Weekly Highlights – September 2015 #3

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Manatt on Health Reform: Weekly Highlights – September 2015 #3

The GAO reports a rise in selection of plans both off and on Marketplaces Hawaii submits the very first 1332 waiver application, having a concentrate on substituting the business mandate and SHOP provisions with pre-existing Condition needs and Rhode Island’s Marketplace reports around the State’s stop by uninsured rates.


GAO Finds Elevated Plan Choice in Individual Markets Off and on Marketplaces

According to a new Government Accountability Office (GAO) report, consumers purchasing individual market plans on / off the ACA’s Marketplaces had utilization of more health plans in 2015 in comparison with 2014. The report learned that the increase in plan choice was most pronounced round the Marketplaces. In 2015, 94% of counties had six or maybe more silver Marketplace plans and 88% of counties had six or maybe more bronze Marketplace plans, in comparison with 80% for groups in 2014. Plan choice remains a lot more robust in the Marketplace, where the quantity of counties reporting six or maybe more silver and bronze plans elevated from 97% to 100% between 2014 and 2015. In reviewing premiums, GAO learned that the least expensive-cost plans inside the individual markets somewhat offered on Marketplaces. Particularly, the least expensive-cost silver plan inside the individual market was provided with industry in 81% of counties examined, an increase of 18 percentage points from 2014. The premiums for least expensive-cost plans in each and every condition varied broadly, even though the study states the cost for your minimum and median premiums for silver plans elevated from 2014 to 2015 in lots of states.

Federal Judge Permits House Republicans to Proceed with Suit Against Federal Government

A U.S. District Court judge ruled the House can proceed having a suit challenging if the Administration unconstitutionally required the “power from the purse” from Congress by spending funds on Marketplace subsidies which were not appropriated by Congress, reports the Washington Publish. The judge also ruled the House cannot pursue another argument within the suit, which alleges the Administration’s delay from the employer mandate violated the Metabolic rate. The Administration is anticipated to attract a greater court prior to the situation is heard, based on Modern Healthcare.

Agent and Broker Hotline to produce for 2016 Open Enrollment

Agents and brokers have a dedicated answering services company for questions relating to clients utilizing, based on Politico. The phone call center hotline is anticipated to become operational by November 1 for the beginning of the 2016 open enrollment period.

Condition State medicaid programs & MARKETPLACE UPDATES:

Hawaii: Draft 1332 Waiver Application Released

The Condition Healthcare Innovation Task Pressure released its draft Waiver for Condition Innovation now prior to public proceedings that started September 14. Hawaii’s draft 1332 waiver, the very first in the united states to be sold, provides waive the ACA’s employer mandate and Small Company Health Options Program (SHOP) Marketplace provisions and replace all of them with the State’s longstanding employer-backed insurance needs underneath the Hawaii Prepaid Healthcare Act (“Prepaid”), that has greater standards compared to ACA. Less than 1% of employers and just one insurer in Hawaii used the State’s SHOP, which closed in June 2015. Underneath the suggested waiver, Hawaii would waive the necessity to conserve a SHOP Marketplace and redirect small company tax credits to premium relief under Prepaid. Because Prepaid is exempt from ERISA regulation, which usually restricts a state’s capability to regulate employer-backed health advantages, The hawaiian islands are likely the only real condition that may strengthen its employer mandate with this particular approach.

Or: State medicaid programs Provider Reimbursement Rates to lower

The Or Health Authority announced that reimbursement rates for that State’s 16 Coordinated Care Organizations (CCOs) will visit .8% in aggregate this season, getting developed new reimbursement rates for 2015 after CMS requested it re-examine its previous rate-setting methodology. The brand new methodology aims to complement payments to risk for every CCO, minimize variability within each region and incorporate data in the State medicaid programs expansion population. All CCOs received sharp rate decreases for adults under 45, with decreases varying from 15% to 46%, while rate changes for other groups were mixed. For instance, the Condition elevated rates for older State medicaid programs people up to 47%. The general effect on individual CCOs underneath the new methodology will be different.

Rhode Island: Marketplace Reports Uninsured Rate Drops to fivePercent

The proportion of uninsured in Rhode Island continues to be reduced by over fifty percent since 2012, from 11% this year to fivePercent in 2015, based on a condition-wide survey commissioned by HealthSource RI. Condition officials credit the decrease to expanded State medicaid programs and also the Condition-based Marketplace. Up to 50 % from the remaining uninsured are qualified for State medicaid programs and the other 41% “would likely qualify” for any federal premium tax credit, based on HealthSource RI. Laptop computer also discovered that 52% of uninsured Rhode Islanders are ages 18-34 which the uninsured have a tendency to earn under 200% from the federal poverty level. HealthSource RI will release additional survey findings associated with access and also the insurance market within the coming days.


Michigan: New Condition State medicaid programs Director Named

Chris Priest, Governor Ron Snyder’s (R) Deputy Strategy Director, was named the brand new Condition State medicaid programs Director and can assume the function October 12. Priest replaces the interim Medical Services Administration Chief, Kathy Stiffler, that has held the positioning because the June retirement of Steve Fitton.

Boise State Broncos: Two Exchange Board People Hired

Two people were put into the Boise State Broncos Medical Health Insurance Exchange board in September: Avoi Jean Fomalot, V . P . of Sales at BenefitSource, who had been hired through the Legislature, and Lisa Farrell Lujan, President of Presbyterian Health Plan (certainly one of four companies offering intentions of the Exchange in 2016), who had been hired through the Governor.



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