March 1, 2018
Reinsurance Funding: It is very likely that if Congress provides funding for reinsurance it will happen this month. The Hill is reporting that the GOP is considering a budget gimmick that would create “savings” such that if reinsurance were funded it would not add to the deficit. The latest configuration of an ACA stabilization bill would include reinsurance funding, loosening restrictions on 1332 waivers but no CSR funding.
Risk Adjustment Lawsuit: A federal judge ruled today that HHS’ risk adjustment formula was “arbitrary and capricious”. In particular, the usage of state average premium and restriction of budget neutrality were illegal. HHS now has the option to file an appeal or make changes to the risk adjustment methodology. Wakely will provide updates as more information becomes available.
Models and More Models: There has been a lot of questions about how the introduction of new products like short-term duration plans or association health plans (AHPs) might affect the individual and small group markets. Avalere recently released projections for AHP effects here and the Urban Institute released its findings on short term duration plans here.
Work Requirements: With work requirements being a highly sought after feature in 1115 Medicaid waivers, it’s become increasingly hard to keep track of which state is proposing what. MACPAC released a useful summary on the state of work requirements.
Apple: Apple is launching medical centers for its employees. The news follows Amazon’s recent announcement that it would be implementing programs for its employees.