Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
By Sara Hansard
Greater state flexibility is among the goals of a new Obamacare final rule from the Trump administration.
The state-friendly provisions in the Health and Human Services Department’s rule issued April 9 include giving states more options to select an essential health benefit (EHB) benchmark plan and to allow its issuers to substitute benefits across EHB categories. The HHS said it also will permit streamlining of the enrollment process through the Small Business Health Options Program (SHOP) Exchanges by eliminating online enrollment requirements.
The final rule, which sets the requirements for the 2019 health insurance exchanges, is the Trump administration’s first major Affordable Care Act final rule. Obamacare has helped expand health-care coverage but has also led to premium spikes and less coverage in the non-group health insurance market—something the administration noted in its April 9 description of the new rule.
St. Louis-based Centene Corp. is the largest exchange operator, with 1.6 million members in 2018. Other major health insurers operating in the Obamacare exchanges include Anthem Inc. and Molina Healthcare Inc. For 2018, nearly 11.8 million people have signed up for insurance on the ACA exchanges.
The rule (RIN:0938-AT12) will be published April 17. Its full title is Benefit and Payment Parameters for 2019.
In an April 9 briefing, federal officials told reporters that the new rule and associated guidance from the HHS will provide a hardship exemption from the ACA’s coverage requirement in certain circumstances. People living in counties with no insurance issuer, or only one issuer, won’t be fined for lacking ACA coverage, Centers for Medicare & Medicaid Services Administrator Seema Verma said.
More than half the U.S. counties only have one issuer; no counties lack an ACA issuer at this time, Verma said.
Hardship exemptions from the coverage requirement also are available for certain people who object to abortion. These exemptions are available for consumers who don’t have have issuers available that decline to cover abortion services, according to the HHS briefing.
These exemptions are available immediately, according to the HHS, even though the rule is for 2019.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)