Ohio passes a budget mandating that the State request a waiver to implement Medicaid Health Savings Accounts; in Nevada, Marketplace enrollees who experienced technical difficulty obtaining coverage are eligible for a tax-penalty exemption; and a national report finds modest increases in 2016 silver plan premiums.
CMS to Provide $7.9 Billion to Qualified Health Plan Issuers
On the heels of announcing an increase in the reinsurance copayment rate, a new CMS report indicates it will pay more than $7.9 billion in reinsurance payments to 437 qualified health plan (QHP) issuers for the 2014 benefit year. The report also noted that the risk adjustment methodology for 2014 “work[ed] as intended,” by appropriately compensating issuers who enrolled high risk patients, including small plans with isolated cases of catastrophically ill individuals as well as issuers with a large share of HIV/AIDS patients, key specialty hospitals in their networks, or a history of serving high-risk individuals as the issuer of last resort.
Changes in 2016 Premiums Modest, According to New Report
A review of the lowest and second lowest cost silver plans in 11 major cities revealed modest changes in premiums for the 2016 benefit year, according to a new report by the Kaiser Family Foundation. The report found that premiums for the second lowest cost silver plan, or benchmark plan, increased by an average of 4.4%. In the same cities last year, the average benchmark plan premium decreased by 0.6%. This year’s differential in the average benchmark plan premium varied significantly across the cities—from a 10.1% decrease in Seattle, Washington to an increase of 16.2% in Portland, Oregon. The report notes that the variation may reflect an assortment of factors, including the composition of the risk pool, the steadiness of enrollment growth, and competitive dynamics. Additionally, this is the first year plans are setting rates based on their previous experiences with these enrollees, though the authors caveat that data from 2014 may reflect some pent-up demand for health services among the previously uninsured. In some states, these rates are still preliminary and may change based on negotiations between issuers and the state.
Supreme Court Allows Some Religious Groups to Avoid Compliance with Contraception Requirement
The Supreme Court issued an order that temporarily allows some religious nonprofit organizations not to comply with the requirement to offer insurance that covers contraceptive services. Under the Supreme Court’s order, the nonprofit organizations also need not satisfy specific regulatory requirements for an exemption or accommodation; instead, the organizations must merely ensure that the government is aware that they are nonprofit religious organizations. The plaintiffs claim that the requirement to submit a form to invoke an accommodation from the contraceptive mandate itself violates the Religious Freedom Restoration Act of 1993, because submitting the form will result in their health insurance issuer or third party administrator covering contraceptives for their employees or students. The United States Court of Appeals for the Third Circuit ruled that the requirement to submit the form did not impose a substantial burden on their free exercise of religion. The Supreme Court’s temporary order enjoining the accommodation will remain in place at least until the Supreme Court decides whether to review the merits of the Third Circuit’s decision.