In the following roundup, PCG health policy subject matter experts reflect upon major policy shifts and changes that have occurred in 2017, as well as preview policy developments expected in 2018. With major announcements that will affect 2018 just within the past couple of months, our subject matter experts have chosen a few key topics to reflect upon and provide insights into the potential future implications and policy directions.

CHIP funding becomes critical issue for many states

States continue to face uncertainty as of December 15, 2017 about Federal funding for the Children’s Health Insurance Program (CHIP).  Congressional authorization of new Federal funds for CHIP expired on September 30, 2017.  States have been operating CHIP since October 1, 2017 on unspent carryover and redistribution payments from prior fiscal years…Read more

HHS termination of CSR payments

The U.S. Department of Health and Human Services (HHS) announced on October 12, 2017 that cost-sharing reductions (CSRs) to issuers of qualified health plans under the Affordable Care Act (ACA) must stop, effective immediately.  That decision regarding CSRs will likely remain in place in 2018 unless the U.S. Senate’s Alexander-Murray bill or comparable legislation is enacted…Read more

Annual proposed Qualified Health Plan certification guidance released

With comments on the yearly Letter to Issuers in the Federally-facilitated Exchanges (Letter) due mid-December, and the finalized Notice of Benefit and Payment Parameter (NBPP) regulations likely to be released in early 2018, readers are reminded to consult the PCG summaries of the proposed guidance. To assist state regulators reviewing the guidance, subject matters experts from PCG have updated our summary of the proposed NBPP for 2019 to include changes proposed in the Letter, and highlighted new policies and procedures in red.

The President’s Executive Order on healthcare

The Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States. directed Federal agencies to explore targeted policy changes to:

• Expand access to Association Health Plan (AHPs)
• Expand the coverage period for Short-Term Limited-Duration Insurance (SLTDIs)
• Expand the use of Health Reimbursement Arrangements (HRAs)

Any changes require further action and, a couple of months out from the Executive Order’s signing, we are still awaiting next steps. Looking into 2018, we will be watching for the content of those proposed regulations to understand their potential impact on fully-regulated markets.

The following news articles were of particular relevance this past year and likely to affect 2018 as well:

• White House releases report on opioid crisis
• White House issues report on the opioid epidemic
• Balance Billing - A Survey Report of Recent Efforts to Protect Consumers
• States seek to intervene in House v. Price lawsuit
• Section 1332 State Innovation Waiver – Recent developments and the newly-released checklist
• The latest news from D.C.