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NAHU Press Statement on Graham-Cassidy Proposal
NAHU has met with bipartisan leadership in the House and Senate, as well as other industry stakeholders, to promote bipartisan measures for market stability. Unfortunately, we do not believe the current Graham-Cassidy proposal serves to stabilize the individual health insurance market and we have significant concerns that the lack of adequate guardrails for states applying for waivers could create instability in the employer-sponsored health plan market.
The proposal would dramatically restructure the ACA from the federal government to the states. While some level of returning decisions to the states is desirable, the scope of restructuring allowable under this proposed legislation is likely to have untended consequences, including a larger number of uninsured individuals, without actually taking the steps needed to stabilize the individual health insurance market.
The proposal would redirect ACA funds back to the states as block grants, allowing states broad authority to determine how to apply these funds. Theoretically, states could take actions that would eliminate important consumer protections rather than just those that impose unnecessary costs in the system, but could also go entirely in the opposite direction and go far beyond ACA requirements, such as adopting single-payer or a public option for one or more markets in the state.
We also have serious concerns with the retention of the Cadillac/excise tax and the Health Insurance Tax (HIT), which, once they are retained in this proposal and redirected to the states in block grants, will effectively make them permanent as states will grow dependent on these funds for implementing their health reforms. The Cadillac tax will impose a 40% excise tax on health plans that exceed certain cost thresholds beginning in 2020, while the HIT is currently under a one-year moratorium and is set to take effect again next year, adding an additional $500 to average premiums per affected family every year.
States would also have greater authority under the proposal to implement changes through the ACA’s state waivers. While NAHU seeks greater flexibility for states to innovate on health reform, we do not believe that the flexibility proposed under Graham-Cassidy is appropriate. The expansion of state waivers without any of the guardrails in effect under the ACA’s current 1332 waiver program could undermine employer-based coverage governed by ERISA, which is one of the indispensable pillars of the employment-based system. We have strong concerns about the potential effect on multi-state employer plans. While some loosening of 1332 waiver restrictions is desirable, some minimum standards are needed to ensure that outcomes are positive rather than detrimental to markets that are not currently at risk.
Finally, the proposal would lead to a chaotic patchwork of 51 different versions of health reform, one for each state plus the District of Columbia. While some state flexibility beyond what is currently allowable is needed, establishing 51 completely different versions of healthcare systems would not only eliminate provisions that protect consumers but would also cause an enormous compliance burden for employers attempting to navigate the various health systems and their corresponding regulations and requirements.
Ensuring private health insurance market stability and competition, as well as improving health coverage affordability, are among NAHU’s top goals. As such, we are unable to support the Graham-Cassidy-Heller-Johnson proposal as it lacks what we believe are the key tenets of market stabilization. We look forward to working with Congress and the administration on bipartisan efforts to improve our healthcare-coverage system and ensure access to high-quality affordable healthcare.
Who is NAHU.Org: The National Association of Health Underwriters represents more than 100,000 licensed health insurance agents, brokers, general agents, consultants and benefit professionals through more than 200 chapters across America.
NAHU’s Washington Update is on hiatus this week. In lieu of our usual collection of articles and podcast, we are summarizing the most recent regulatory action affecting our industry.
On Wednesday, February 15, the Trump Administration released its first significant health policy action, a proposed rule intended to stabilize the individual and small group private health insurance markets for 2018. The 71-page proposal released by the Centers for Medicare and Medicaid Services (CMS) includes the following significant components:
Comments are due on this proposed rule by March 7, 2017. NAHU is currently evaluating the provisions of the proposal and how they may impact our members, their clients and the stability of the individual and small group markets. CMS has also asked for additional market stabilization ideas to be submitted, so NAHU will provide them with a detailed letter on behalf of the membership about both the potential of the proposed rule and our additional ideas to improve the private individual and group marketplaces.
National Association of Health Underwriters 1212 New York Ave NW, Ste 1100, Washington, DC 20005
Ph. 202.552.5060 Fax 202.747.6820 www.nahu.org
Views 9 questions for the Trumpcare architects
By Perry Braun
As a new plan is presented for debate and discussion by the Trump administration — with the goal of building an affordable plan — here are my questions:
With the new administration committing to repeal and replace Obamacare, we are all left to wait and see the details of the plan — and adjust accordingly.”
Read Full Article Here: http://bit.ly/2knbT69
One of Trump’s top campaign promises was to repeal and replace the Affordable Care Act, commonly called Obamacare.
His first official act in office was declaring his intention to do so. Congressional Republicans have been working to do just that since their term started January 3, though there’s dissent among Republicans over whether or not to complete the repeal process before a replacement plan is finalized and strident Democratic resistance to any repeal of the ACA.
On Wednesday, the Trump Administration submitted a proposed rule to the Office of Management and Budget designed to help stabilize the ACA marketplaces. Details on the rule are not currently available as it has not yet been published, but it is expected to address a number of immediate fixes to stabilize the marketplaces in the coming year. The administration is also in the process of releasing an executive order directing the Department of Labor to review the fiduciary rule, which currently imposes significant requirements on health savings accounts. NAHU will continue to monitor these regulatory items and will update members as details become available. The proposed rule on stabilizing the marketplace is the first regulation directed at the department of Health and Human Services since President Trump took office two weeks ago.
NAHU has called on the Trump Administration, and previously the Obama Administration, to implement several changes that would improve stability in the individual marketplaces. We have suggested that the administration could restrict the use of special enrollment periods (SEPs) to reduce their abuse and also implement more stringent documentation requirements. Similarly, we have called on reducing the current 90-day grace period for individuals with premium tax credits down to 30 days for non-payment. We also suggest allowing “grandmothered” policies to continue beyond their 2017 expiration date and removing limitations on “grandfathered” policies. And we have called on the administration to simplify the employer reporting requirements. NAHU CEO Janet Trautwein’s testimony before the Senate Health, Education, Labor and Pensions Committee included many of these suggestions.
The proposed rule follows an executive order (EO) issued by President Trump on Monday, which requires that for every new regulation that is issued, two previous regulations must be eliminated. Based on interim guidance released today and a previous executive order from 1993 that is still in effect, the rule will apply to any “significant” regulation that imposes an annual economic cost of $100 million or more. Agencies issuing regulations starting on September 30 will need to identify two existing regulations to eliminate prior to the new regulation being issued, as well as fully offset total incremental cost of the new regulation. Regulations addressing health, safety or financial emergencies may request a waiver from this requirement. This EO order fulfills a campaign pledge that was part of President Trump’s 100-day plan, and follows a listening session last Monday with a dozen business executives from several large companies where he promised to cut regulations by 75%. President Trump has issued seven executive orders and 11 presidential memorandums since taking office on January 20.
NAHU is continuing to work with the Trump Administration and congressional leadership to determine the best approach and timing for change in our healthcare system. We will continue to update you as any other regulatory changes, EOs or legislation are released. In the meantime, all statutes and regulations enacted by the ACA continue to be in place and NAHU members should continue to work with their clients to be in compliance with the law. Additionally, if you have suggestions regarding our work with the Trump Administration and members of Congress on the future plans to reform the ACA that you would like to share with NAHU, you can send your thoughts and ideas to ACAreform@nahu.org.
Health insurance companies are bailing and co-ops are failing as Obamacare barrels down the road to collapse.
Health policy experts predict the Affordable Care Act will continue to muddle along for the next few years at least. But when the breaking point comes, experts warn the debate will center on whether to move toward a free market system or double down on government takeover of healthcare. Read More Here: Get Ready for Hillarycare, Part II