Health Reform Weekly
A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.
Week of December 9, 2013
With implementation of the Affordable Care Act (ACA) riding a wave of mostly good news for a change, some were ready to declare that Obamacare had turned a corner last week. An improved Healthcare.gov website enabled the first true surge in health insurance exchange enrollments, and President Obama felt comfortable in launching a new push to promote the benefits of Obamacare. But the rollout is not out of the woods yet. Insurers warned last week that Healthcare.gov continues to generate faulty data and that the new surge in enrollments could worsen problems come January 1, 2014, when coverage actually goes into effect. In addition, it still remains unclear whether the participation of young people needed to help pay for the law’s new benefits will materialize. One new survey released last week appeared to show that young people are quite interested in new, affordable health coverage options, while a Harvard poll found that most millennials believe Obamacare will result in higher costs and worse quality of care.
The federal Department of Health and Human Services (HHS) also has announced that it is delaying the launch of the website for the federal Small Business Health Options Program (SHOP) until November 2014, a full year later than originally planned.
Federal
The Senate is scheduled to convene this week after a two-week recess. This week, the Senate and House are scheduled to be in session concurrently. Since this is the only week this month in which that happens, it raises questions about prospects for a budget agreement ahead of a Friday deadline. Senate Budget Committee Chairwoman Patty Murray (D-WA) and House Budget Committee Chairman Paul Ryan (R-WI) are believed to be nearing an agreement that, in part, would use higher revenue from fees to reduce across-the-board cuts to defense and domestic programs. However, it remains unclear whether an agreement can be completed before the House adjourns for the year on Friday.
In addition to budget negotiations, the Medicare provider reimbursement formula will draw significant attention this week. The Senate Finance Committee and House Ways & Means Committee are planning to mark up bills. “Pay-fors” (new revenue sources or budget cuts) are not expected to be considered in the mark-ups, increasing the likelihood that a short-term patch will be needed to avoid a 20 percent cut to Medicare provider payments set to begin on January 1. House Majority Leader Eric Cantor (R-VA) has indicated that the House could take up a short-term SGR patch this week.
States
ARIZONA: Insurance Director Gerrie Marks advised insurers that they may renew non-grandfathered individual and small group employer policies, provided that the renewal dates take effect prior to January 1, 2014. No carrier is required to extend policies. The director's decision was based on the applicable state law prohibiting issuance of non-ACA compliant plans after January 1, 2014. The advisory was also based on what would be least disruptive to the market, in view of the compressed time frame for implementation.
CALIFORNIA: The state health insurance exchange, Covered California, has announced that it has added to staff to handle a significant acceleration in applications for coverage in late November. The exchange reported that it has received 431,756 enrollment applications through November 30, the highest numbers reported in the country. Enrollment numbers for November are expected shortly.
CONNECTICUT: Enrollment figures released by Access Health CT last week show that as of December 4, 2013, 22,904 individuals have signed up for coverage since October 1 as well as 100 small employers with 536 employees. Sixty percent of enrollees signed up for private insurance and the balance for Medicaid. Of those who signed up for private insurance, 41 percent are over age 55, while 26 percent are under age 35. Seventy six percent of the applications were submitted online, 22 percent through the call center and 2 percent on paper.
ILLINOIS: The Department of Insurance (DOI) has announced it will allow insurance companies, as proposed by President Obama, to renew a number of health plans in the individual and small group markets that do not meet certain ACA requirements. The DOI is working with insurance companies that choose to extend the terminated or cancelled coverage to quickly renew such policies. In step with the president’s announcement, policies in effect on Oct. 1, 2013, in the individual or small group market, can be renewed for a policy year starting between Jan. 1, 2014, and Oct. 1, 2014.
NEVADA: The Division of Insurance issued a press release last week saying it will not take action on President Obama’s “keep-what-you-have” initiative, citing the current availability of early renewals. The DOI also believes the president’s transitional proposal conflicts with statutory constraints imposed by recently enacted ACA alignment legislation.
UTAH: Commissioner Todd Kiser informally announced to an industry group that the Department of Insurance is leaving the decision of whether to extend policies into 2014 up to each insurance carrier. The regulator will assist any company choosing to extend coverage by expediting requests for rate increases. A formal bulletin is expected to be issued shortly.
Resources
Health Reform Connection
America's Health Insurance Plans
Aetna 2011 Annual Report
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