The $1.3 trillion omnibus spending bill the House passed Thursday lacks funding for two things insurers want: cost-sharing reduction payments and federal reinsurance. That likely means they'll hike premiums and rethink participating in the individual market for 2019.
After the House scuttled a measure to fund CSRs and reinsurance in the omnibus spending bill, the leading GOP negotiators in the Senate revived a fight to get their stabilization bill a vote in the upper chamber.
The House has dashed insurers' hopes that its mega-spending deal would include CSRs and reinsurance for the individual market as Congress goes down to the wire to avert another government shutdown.
Highmark Health, a Blues plan that owns Allegheny Health Network, recorded higher operating gains and revenue in 2017, driven by the continued turnaround of its ACA insurance business, growth in its Medicare Advantage segment, and the sale of a portion of its vision insurance business.
Observers are wondering if Idaho officials are negotiating with the Trump administration behind the scenes to meld their proposal for cheaper, leaner individual-market plans with the administration's plan to let insurers offer short-term products.
Health insurance groups were guardedly relieved by the CMS' decision to block Idaho's move to allow noncompliant plans, as they feared other GOP-led states similarly would seek to unravel the Affordable Care Act's consumer protections.
The White House is urging Congress pass legislation that doesn't authorize cost-sharing reduction payments and reinsurance for 2017, even though insurers had to contribute to the program.
The White House is pushing Congress to adopt several conservative policies including allowing long-term use of short-term plans and seniors being charged higher premiums. In exchange, it will support bringing back cost-sharing reduction payments for individual market enrollees.
A federal appeals court has requested additional information from the U.S. House of Representatives and HHS before it considers signing off on their settlement over cost-sharing reduction payments for insurers.
Disappointed that Congress failed to repeal and replace the Affordable Care Act, red-state lawmakers continue to look for ways to take down the law. But many are finding that they must balance that goal with the need to shore up insurance exchanges.
A federal judge ruled that HHS couldn't use statewide average premiums to come up with its risk-adjustment formula because the agency wrongly assumed the ACA required the program to be budget-neutral. However, most of the co-op's suit was dismissed.
Federal lawmakers soon may have financial justification for funding cost-sharing reduction payments for insurers as well as reinsurance, when a new government report shows CSRs will save the government $32 billion if they're funded for the next three years.