‘What The Health?’ It’s Nerd Week

Podcast: KHN’s ‘What The Health?’ It’s Nerd Week

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The Trump administration this week issued the rules governing next year’s Affordable Care Act insurance marketplaces, and they make some potentially large changes that could result in higher premiums and fewer benefits.

Meanwhile, states are going different ways in addressing the health insurance markets in their states in response to the federal activity. And House Speaker Paul Ryan announced his retirement — leaving an intellectual void among House Republicans when it comes to health care.

This week’s panelists for KHN’s “What the Health?” are:

  • Julie Rovner of Kaiser Health News
  • Stephanie Armour of The Wall Street Journal
  • Sarah Kliff of Vox.com
  • Paige Winfield Cunningham of The Washington Post

Among the takeaways from this week’s podcast:

  • The federal rules for the ACA’s marketplaces could dramatically alter how state regulators determine what plan benefits must be covered.
  • Those rules also change some conditions allowing people to qualify for exemptions to the requirement to have coverage — and they make those exemptions retroactive to 2017. So, some people who opted not to buy insurance and paid a penalty for 2017 may be able to file for refunds from the government.
  • Insurance companies are concerned about a number of the new provisions, including those that might drive healthy consumers away from the marketplaces and alter how insurers are compensated for having unusually high numbers of expensive customers.
  • An announcement from the White House this week said the administration is hoping to extend the work requirements that some states are seeking for Medicaid to other safety-net programs.
  • California and Maryland are among the states looking at ways to shore up their individual insurance markets in light of the changes being made at the federal level.

 

New Jersey pushes back on ACA moves

New Jersey pushes back on ACA moves

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The New Jersey legislature yesterday approved two big bills designed to counteract some of President Trump’s changes to the Affordable Care Act and stabilize the state’s individual insurance market.

The bills: One would begin the process of seeking a federal waiver to establish a reinsurance program. The other would create an individual mandate in the state.

  • If Gov. Phil Murphy signs off, New Jersey would become only the second state in the country to have an individual mandate, and the first state to pass one since the federal coverage requirement was repealed.
  • The mandate bill would require New Jersey residents to buy coverage that meets New Jersey’s standards — not the federal government’s. And New Jersey already bans the sale of short-term health plans, which the Trump administration is expanding.
  • Together, this means that New Jersey’s market would function a lot like the pre-Trump ACA.

Why it matters: Some ACA allies have pinned an awful lot of hope on the states to counteract the administration’s policy moves. That’s only likely to happen in blue states, and even there, the ultimate effects will probably be limited. But if Murphy signs these bills, they would likely give other blue states some encouragement to proceed.

Go deeper: Freelance health care journalist/analyst Andrew Sprung has written a lot about how these measures could preempt the administration’s priorities.