Senate Dems Attempt To Undermine State Flexibility, Affordability & Choice In Health Care

Twelve States Using This Waiver Authority Have Seen Premiums Decline By An Average Of 16.9 Percent In Their First Year

“Avalere’s analysis finds that among the 12 states with state reinsurance programs, premiums were 16.9% lower, on average, in the first year of enactment compared to what they would have been without the reinsurance program (Table 1). The premium reductions ranged from -6% to -43.4%.” (“State-Run Reinsurance Programs Reduce ACA Premiums by 16.9% on Average,” Avalere, 10/29/2019)

• “In addition, Avalere’s analysis estimates that, during the first year of enactment, reinsurance programs led to lower federal spending on APTCs of nearly $1 billion (Table 1) compared to what the federal government would have been spent without a reinsurance program.” (“State-Run Reinsurance Programs Reduce ACA Premiums by 16.9% on Average,” Avalere, 10/29/2019)

Even Democrat Governors Have Eagerly Sought This Flexibility And Freedom From Obamacare’s Burdens

COLORADO

GOV. JARED POLIS (D-CO): “For the first time in history, Coloradans in the individual health insurance market will save an average of 18.2 percent next year. Finally, we’re driving insurance premiums down.” (Colorado Division of Insurance, Press Release, 7/31/2019)

COLORADO’s FULL CONGRESSIONAL DELEGATION: “We write to request the U.S. Department of Treasury and the U.S. Department of Health and Human Services give their fair and full consideration to Colorado’s application for a Section 1332 State Innovation Waiver. This is an urgent matter because the Colorado Division of Insurance will be reviewing health insurers’ individual market rates for the 2020 plan year this summer and must finalize the approval of those rates by October 1, 2019.” (Sen. Michael Bennet et al, Letter to Sec. of Treasury Mnuchin and Sec. of Health and Human Services Alex Azar, 5/23/2019)

• “The Colorado General Assembly Passed House Bill 19-1168 in early May. The bill authorized the Division of Insurance to seek a waiver in order to establish a state-based reinsurance program to address the rising premiums in our state. It was bipartisan legislation, and Colorado Governor Jared Polis strongly supported it. … Without this program, Colorado will continue to see premiums rise, leading to higher federal payments of advance premium tax credits. On behalf of our constituents, we urge you to complete your full and fair consideration of Colorado’s waiver application as soon as possible.” (Sen. Michael Bennet et al, Letter to Sec. of Treasury Mnuchin and Sec. of Health and Human Services Alex Azar, 5/23/2019)

• Signatories: Sen. Michael F. Bennet (D-CO), Sen. Cory Gardner (R-CO), Rep. Diana DeGette (D-CO), Rep. Joe Neguse (D-CO), Rep. Scott Tipton (R-CO), Rep. Ken Buck (R-CO), Rep. Doug Lamborn (R-CO), Rep. Jason Crow (D-CO), Rep. Ed. Perlmutter (D-CO) (Sen. Michael Bennet et al, Letter to Sec. of Treasury Mnuchin and Sec. of Health and Human Services Alex Azar, 5/23/2019)

MONTANA

GOV. STEVE BULLOCK (D-MT), Democrat Presidential Candidate: “We are taking action for the Montanans who purchase insurance on the individual marketplace and have been burdened by unaffordable health care costs due to federal inaction … The Montana reinsurance program will lower insurance premiums, make it possible for more Montanans to enroll by driving down costs, cultivate greater certainty in the market and protect consumer’s choices.” (State of Montana, Press Release, 8/16/2019)

“Governor Steve Bullock today announced approval of Montana’s reinsurance waiver by the Center for Medicare and Medicaid Services (CMS) to lower healthcare premiums and bring stability to the market. … The approval of the waiver will allow the state to create a reinsurance program that will reimburse costs for high-cost claims, so those claims won’t factor into individual marketplace premiums in the next year. Studies estimate the reinsurance program could lower premiums by up to 9 percent in Montana.” (State of Montana, Press Release, 8/16/2019)

• “In May, Governor Bullock signed Senate Bill 125 that authorized Montana to apply for a State Innovation Waiver from the federal government. The bill was drafted by the working group established by Governor Bullock that included the Governor’s Office, the Montana Department of Administration, legislators, the Office of the Montana State Auditor, and representatives from insurance companies who sell on the individual marketplace.” (State of Montana, Press Release, 8/16/2019)

RHODE ISLAND

GOV. GINA RAIMONDO (D-RI): “It is critical for Rhode Islanders to have access to quality, affordable health insurance options, and this reinsurance program is helping to make that possible. … We are thrilled that as premiums continue to increase across the country, Rhode Islanders on the individual market will actually see their premiums go down.” (Rhode Island Governor's Office, Press Release, 9/3/2019)

“This morning at the Blackstone Valley Community Health Center's Neighborhood Health Station in Central Falls, Governor Raimondo was joined by OHIC Commissioner Marie Ganim and HealthSourceRI Director Zachary Sherman as she announced progress Rhode Island has made keeping health insurance costs low. Due in large part to the reinsurance program created in the FY20 state budget and approved by the US Department of Health and Human Services last week, average premiums for Rhode Island consumers on the individual market will go down in 2020. This is the first time in recent history that costs have gone down on average for any consumer group.” (Rhode Island Governor's Office, Press Release, 9/3/2019)

• “The reinsurance program Governor Raimondo introduced in her FY20 budget originated as a recommendation from the RI Market Stability Workgroup and was approved by the General Assembly in July. … This year during the rate review process, insurers were asked to submit rates with reinsurance, and without. Without the reinsurance program, average individual rates would have increased up to 7% higher than 2019 rates. With the reinsurance program, on average Rhode Islanders on the individual market will be paying less in premiums in 2020 than they did in 2019.” (Rhode Island Governor's Office, Press Release, 9/3/2019)

DELAWARE

“The Department of Health and Social Services (DHSS) received approval today from the Centers for Medicare and Medicaid Services (CMS) for a 1332 State Innovation Waiver under the Affordable Care Act to create a reinsurance program beginning in 2020 as a way to reduce premiums by up to 20 percent in Delaware’s individual health insurance market.” (Delaware Department of Health and Social Services, Press Release, 8/20/2019)

• DEPARTMENT OF HEALTH AND SOCIAL SERVICES SECRETARY DR. KARA ODOM WALKER: “We are grateful to CMS for approving Delaware’s 1332 State Innovation Waiver application that will enable us to establish a reinsurance program in our state … We expect that the reinsurance program will further stabilize the individual health insurance market and make premiums more affordable for Delawareans who need such coverage.” (Delaware Department of Health and Social Services, Press Release, 8/20/2019)

• INSURANCE COMMISSIONER TRINIDAD NAVARRO: “The number one complaint/comment we receive from consumers at the Department of Insurance is the high cost of health insurance, especially from those who are not eligible for tax credits … With this new waiver program, people who earn above 400 percent of the federal poverty level, small business owners, and those who are not covered by their employers will save up to 20 percent on their health insurance premiums in the individual market. My office will continue to work to seek any and all means to help make health insurance more affordable for Delawareans.” (Delaware Department of Health and Social Services, Press Release, 8/20/2019)

The Trump Administration’s Expanded New Guidance ‘Does Nothing To Erode’ Pre-Existing Condition Protections ‘Which Cannot Be Waived’

SEEMA VERMA, Administrator of the Centers for Medicare and Medicaid Services: “I want to make clear that a section 1332 waiver cannot undermine coverage for people with pre-existing conditions.” (Seema Verma, Letter To Rep. Walden, 5/7/2019)

• ADMINISTRATOR VERMA: “To be very clear, the 2018 guidance does nothing to erode the PPACA's pre-existing condition provisions, which cannot be waived under section 1332. Section 1332 does not permit states to waive Public Health Service Act requirements such as guaranteed availability and renewability of health insurance, the prohibition on using health status to vary premiums, and the prohibition on pre-existing conditions exclusions. Furthermore, a section 1332 waiver cannot be approved that might otherwise undermine these requirements. This Administration stands committed to protecting people with pre-existing conditions.” (Seema Verma, Letter To Rep. Walden, 5/7/2019)

‘The New Guidance Gives States More Flexibility To Address Problems’ Caused By Obamacare ‘And To Give Americans More Options To Get Health Coverage’

CENTERS FOR MEDICARE AND MEDICAID SERVICES: “The new guidance gives states more flexibility to address problems caused by the PPACA and to give Americans more options to get health coverage that better meets their needs. Under this new policy, states will be able to pursue waivers to improve their individual insurance markets, increase affordable coverage options for their residents, and ensure that people with pre-existing conditions are protected.” (“FACT SHEET: State Relief and Empowerment Waiver Guidance,” Centers for Medicare and Medicaid Services, 10/22/2018)