Iowa withdraws waiver request; ACA outreach cut likely to lower enrollment

Iowa welcome sign
The Iowa Stopgap Measure was more conservative and far-reaching than the Section 1332 waivers requested by other states. (Getty/Thinkstock)

Blaming the Affordable Care Act’s “inflexible” regulations, Iowa officials said on Monday that they would withdraw their application for a state innovation waiver aimed at stabilizing the individual market.

“The Stopgap Measure was an innovative solution to help thousands of Iowans,” Iowa Insurance Division Commissioner Doug Ommen said. “Unfortunately, Obamacare’s waiver rules are so inflexible that the Stopgap cannot be approved under terms that would be workable for Iowa.”

Indeed, the Iowa Stopgap Measure was more conservative and far-reaching than the Section 1332 waivers requested by other states. According to one policy expert, the state’s plan would amount to “rewriting the ACA.”

Nevertheless, a news report earlier this month indicated that President Donald Trump himself phoned federal health officials to ask them to deny Iowa’s waiver. When contacted previously by FierceHealthcare, the Centers for Medicare & Medicaid Services did not offer any comment on the state’s waiver application.

The outlook isn’t totally bleak for Iowa, however. Medica will offer coverage on the state’s exchange despite previously mulling an exit after Aetna and Wellmark Cross and Blue Shield pulled out.

ACA advertising cuts could mean 1.1M dip in enrollment

The Trump administration’s decision to cut spending on Affordable Care Act promotional activities by 90% will have a significant impact during the upcoming open enrollment period, according to a new analysis.

Joshua Peck, the chief marketing officer for Healthcare.gov under the Obama administration, estimates that the funding cut will result in 1.1 million fewer people enrolling in coverage under the best-case scenario. He explains in a post on Medium that he arrived at that conclusion by extrapolating the results of past government studies on the efficacy of ACA outreach, plus taking into account myriad other factors.

In addition, Peck notes that those lost enrollments will most likely be younger, healthier people, as those are the individuals who respond the most to outreach.

Judge skeptical of states’ attempt to force feds to pay subsidies

During a hearing on Monday, U.S. District Judge Vince Chhabria seemed reluctant to grant a motion from certain states seeking to stop the Trump administration from cutting off funding for cost-sharing reduction payments, the Associated Press reports.  

Chhabria is expected to rule today on the motion, which was filed on behalf of attorneys general from 18 states and the District of Columbia earlier this month. Their argument is that the end of CSR funding would destabilize the individual insurance markets, but as Chhabria pointed out while questioning an attorney from California, many states have already taken steps to diffuse the impact of CSR uncertainty.

“The state of California is standing on the courthouse steps denouncing the president for taking away people’s healthcare, when the truth is that California has come up with a solution to that issue that is going to result in better healthcare for a lot of people,” Chhabria said.

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