Payer Roundup—Insurance groups call for HRA protections; Maine governor signs Medicaid expansion

Affordable Care Act highlighted
Insurance groups say a proposed rule to allow workers to use their health reimbursement arrangements to buy short-term plans that aren't required to cover pre-existing conditions could be costly. (Getty/Ellenmck)

Insurance groups warn about need for HRA protections

America's Health Insurance Plans (AHIP), the Blue Cross Blue Shield Association and the Association for Community Affiliated Plans (ACAP) are opposing a Trump administration proposal to allow usage of health reimbursement arrangements to buy short-term limited duration health plans. 

"Enforceable safeguards and non-discrimination protections are essential for these options to work for Americans," AHIP wrote in its comments in response to the proposal. 

The proposed rule would allow workers to use their HRAs to buy the short-term plans that are not required to comply with the Affordable Care Act or to cover people with pre-existing conditions. 


13th Partnering with ACOS & IDNS Summit

This two-day summit taking place on June 10–11, 2019, offers a unique opportunity to have invaluable face-to-face time with key executives from various ACOs and IDNs from the entire nation – totaling over 3.5 million patients served in 2018. Exclusively at this summit, attendees are provided with inside information and data from case studies on how to structure an ACO/IDN pitch, allowing them to gain the tools to position their organization as a “strategic partner” to ACOs and IDNs, rather than a merely a “vendor.”

ACAP warned its analysis found the proposal would be costly and "could result in sizable premium increases and enrollment losses in the ACA-compliant individual market, especially if certain key guardrails included in the proposed regulation are relaxed." Depending on the uptake of these arrangements and the health status of people who shift from group coverage to the ACA-compliant market, this rule could raise premiums by up to 83%, they said. 

Maine governor seeks Medicaid expansion

Newly elected Maine Gov. Janet Mills has signed an order to expand Medicaid in the state, fulfilling a campaign promise to make it her first order of business in office if elected.

Mills, a Democrat, sought to reverse delays to expansion imposed by her Republican predecessor Paul LePage after voters approved the expansion in 2017. (The Press Herald)

Pelosi signals Medicare-for-All support

Under the new Democratic majority in the House of Representatives, Speaker Nancy Pelosi said she would support holding future hearings to evaluate "Medicare for All," The Hill reported Thursday. 

Party leaders have been considering whether to push forward on the single-payer idea or to focus on more modest goals. (The Hill) (The Wall Street Journal)

AAAHC 'deemed status' renewed for accreditation of ASCs

The Centers for Medicare & Medicaid Services has renewed the Accreditation Association for Ambulatory Health Care’s (AAAHC) deemed status for ambulatory surgery centers (ASCs) for another six years.

That means AAAHC accreditation continues to satisfy the Medicare Conditions for Coverage for ASCs. (AAAHC)

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