AFFORDABLE CARE ACT (Washington Update, November 30, 2018)

REMEMBER: 2019 Open Enrollment runs from Nov. 1 through Dec. 15, 2018.
Waivers Will Allow States to Alter ACA Rules
On November 29, CMS provided details about specific ways that states can utilize new guidance on the ACA’s “Section 1332 Innovation Waivers,” now called “State Relief and Empowerment Waivers.” That guidance was issued and became effective on October 22, but is open to public comment until December 24. (See October guidance; press release; fact sheet.)
According to a November 29 CMS press release, states can apply for several types of waivers that would allow states to:

• establish accounts for consumers to pay both premiums and out-of-pocket health expenses;

• develop a new premium subsidy structure and decide how those premium subsidies should be targeted;
• set the rules for what type of health plan is eligible for state premium subsidies to give people access to more health plan options; and
• implement risk stabilization strategies to address the costs of high risk individuals to reduce premiums in the market for everyone.

Details are provided in a CMS Fact Sheet on waiver concepts.

As explained in the October 31 Update (under “Your Input Sought”), the October will let states allow the sale of insurance policies that do not meet all of the ACA’s standards. These policies may provide less robust coverage than would be allowed under previous guidance, and would not necessarily have to cover pre-existing conditions. Based on the new details, states may also alter the way that federal premium subsidies are used. See Trump Administration Allows States to Loosen Obamacare Coverage Requirements (The Hill, 11/29/18).

Fewer People Are Buying Obamacare Plans as Trump Pushes Other Options
(Bloomberg, 11/28/18)

WORTH REPEATING: INSURANCE BUYERS BEWARE
Some ads, websites, and robocalls advertise sham health plans, sometimes using the names of legitimate insurance companies. Consumers should purchase insurance only through HealthCare.gov, their state Marketplace, or through a broker they know to be legitimate, and never from anyone who calls them. See Experts Advise Hanging Up If A Robocall Is Offering to Sell You Health Insurance (California Healthline, 11/7/18)