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Thursday, Jun 9 2016

Full Issue

HHS Unveils Rules To Limit Short-Term Health Policies, Strengthen Marketplaces

These plans are often cheaper but less comprehensive than those sold on the health law marketplaces. The proposed rules would limit their use to three months.

The Obama administration is seeking to limit short-term health policies that include features largely banned under the Affordable Care Act, a proposal that could crimp a profitable and growing business for some insurers. Under a proposed rule released Wednesday, insurers would only be able to offer short-term health policies that last less than three months, and the coverage couldn鈥檛 be renewed at the end of that period. The proposal seeks to close a gap that has let healthier consumers purchase short-term plans that could last for nearly a year, sometimes using them as a cheaper substitute for ACA plans. (Wilde Mathews, Radnofsky and Armour, 6/8)

The Department of Health and Human Services (HHS) on Wednesday announced a range of steps aimed at improving the health of the ObamaCare marketplaces. The moves are aimed at improving the mix of healthy and sick enrollees, known as the 鈥渞isk pool.鈥 (Sullivan, 6/8)

The department also announced it will propose a separate rule later this year that would include an adjustment factor for partial-year enrollees as part of the risk adjustment model beginning next January. A third proposed rule the department says is coming this year would include prescription drug utilization data into the risk adjustment model starting during the 2018 benefit year. Such proposed rules would ensure consumers are using temporary insurance plans for when they are intended, typically when someone is in the middle of a transition in their life that would affect their existing coverage, HHS said in a release explaining the rules. (McIntire, 6/8)

The plans, designed for people in between jobs or in need of temporary insurance until they secure a regular policy, are cheaper than regular insurance plans. But they also can lack features that the health law requires for other policies, such as coverage for preexisting medical conditions, maternity care and prescription drugs. In addition, insurers are allowed to refuse to sell short-term plans to people they think will run up large medical costs, and insurers can also cap the maximum amount they will pay. Both practices are banned for regular policies under the health law. (Rau, 6/9)

HHS plans to limit the use of short-term health plans and tweak the Affordable Care Act's risk-adjustment program for health plans to account for people who need coverage for only part of the year. The program will also now track prescription drug usage as a factor in assessing risk. (Dickson, 6/8)

A new study by the Federal Reserve Bank of New York released this week confirms that the expanded Medicaid plan has indeed eased the financial anxiety of millions of poor people, primarily by reducing the size of debts sent to collection agencies. (Pianin, 6/8)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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