Payer Roundup—Trump administration rejects Ohio's request to end individual mandate

Trump administration rejects Ohio's request to end individual mandate

The federal government rejected the Buckeye State's request to end the individual mandate under the Affordable Care Act.

The Centers for Medicare & Medicaid Services said in a letter (PDF) last week that Ohio's request was incomplete and did not include a plan to ensure the number of people with insurance doesn't fall. 

According to the letter, the state sought to be the first to be rid of the individual mandate as Congress' 2017 tax law only reduced the noninsurance penalty to $0 and did not completely get rid of the mandate itself.  

The waiver also did not cite a reason for the request, the agency said. (Letter [PDF])

Medicaid more cost-effective than ACA?

Insuring people through the ACA marketplace costs 43% more than through Medicaid, according to an analysis from a former exchange insurer.

UnitedHealth Group, which left the marketplace two years ago, said it spent about $9,400 a year to cover an eligible low-income adult's enrollment in the exchanges, compared to $5,400 under Medicaid. 

The insurer blamed a higher-than-expected risk pool and lower-than-expected enrollments for why the marketplace has "fallen short" of its goals.

"Exchanges have failed to achieve enrollment expectations and currently cover far fewer people than other coverage platforms," the insurer said. "Exchanges face low expectations for new growth and overall future participation." (Analysis)

Michigan removes 'racist' Medicaid work exemption

The sponsor behind Michigan's proposed work requirement bill says state lawmakers are removing an exemption that some have criticized as racist.

State Sen. Mike Shirkey, a Republican, told the Associated Press that a provision which would allow people living in counties with 8.5% or higher unemployment meet the requirement by researching for jobs unless the unemployment rate drops below 5%, which critics said favored white residents in rural areas.

The state Senate passed the bill last month and a new version could appear as early as this week. (Associated Press)