WASHINGTON, DC: More than 75 Congressional staffers and industry stakeholders attended arecent briefing on the role of federal waivers in helping states contain rising health insurance costs presented by the Council for Affordable Health Coverage (CAHC).
Section 1332 of the Affordable Care Act enables states to waive certain elements of the healthcare law – benefit requirements, enrollment periods, tax credits – if the state approves reforms that meet the same benchmarks.
CAHC has been a longtime advocate of greater flexibility for states under the 1332 program and has touted the waivers as an opportunity for state-led health insurance reforms in lieu of Congressional action. CAHC personnel, including its President, Joel White, and Chief Economist, Jeff Lemieux, consulted for the state of Wisconsin's 1332 waiver application to create a reinsurance program, which was recently approved by the Trump administration.
J.P. Wieske, Deputy Commissioner of Insurance for the State of Wisconsin, spoke at the briefing; describing Wisconson's waiver submission process and urging more state flexibility on plan design under the healthcare law.
Other speakers echoed Wieske's remarks, with Brian Webb, Assistant Director of Health Policy and Legislation at the National Association of Insurance Commissioners (NAIC)telling attendees, "We have a population out there that needs our help and needs it fast.”
Scott Keefer, Chairman of the Board of Directors for the Minnesota Comprehensive Health Association and Vice President of Public Affairs at Blue Cross and Blue Shield of Minnesota, discussed how premiums in Minnesota had increased unsustainably year-over-year but declined once the state received its 1332 waiver approval for a reinsurance program of their own.
“It is not American to have to spend 30 percent of your income on health care premiums," Keefer explained.
CAHC President Joel White rounded out the briefing with a presentation highlighting the grim state of rising premiums on ACA exchanges and explaining the current regulations surrounding 1332 waiver eligibility. White also touted CAHC's proposed solutions to make 1332 waivers deliver greater benefit to more people, including removing the requirement on state legislatures to first codify their waiver application as a state law, passage of seed funding in Congress to support state reinsurance programs, and allowing states to disburse subsidies for policies purchased off-exchange, among other measures.
White released the following statement reacting to the briefing and CAHC's advocacy moving forward:
"With Obamacare premiums continuing to rise across the country and Congress deadlocked on the way forward, it is increasingly clear that states may need to take matters into their own hands. CAHC believes the administration is poised to issue regulations allowing greater state flexibility under Section 1332 waivers but, even under the current law, with the numbers of enrollees in on-exchange plans who qualify for the Advance Premium Tax Credit (APTC) at or above 80 percent in most states, reinsurance programs like the one recently approved in Wisconsin could offer a tremendous opportunity for states to stabilize their markets," said CAHC President Joel White."Wisconsin, for example, anticipates an 83 percent pass-through rate under its reinsurance program. This means that, for every dollar the state spends on their program, 83 cents would be reimbursed from Washington, thereby offsetting much of their original investment. We believe that success can be replicated in other states nationwide. We look forward to our continued work to maximize opportunities for states and individual consumers under the waiver program."
Materials from the Briefing:
- CAHC PowerPoint Presentation on the State of 1332 Waivers
- Handout: State Opportunities to Reduce Premiums, How Section 1332 Waivers Can Launch State-Led Health Reform
- Handout: Untie States' Hands by Reforming Obamacare Waivers
- Bloomberg Law: "HHS Expected to Allow States to Waive Obamacare Provisions"
- Inside Health Policy: "Stakeholders Pitch Reinsurance to Congressional Staffers"