Thursday, August 16, 2018

Good News in New Jersey: CMS approves state reinsurance waiver

Some good ACA news out of New Jersey: CMS has approved the state's reinsurance waiver proposal, designed to reduce premiums by 15% in 2019.

The bill mandating pursuit of this waiver was paired with a bill establishing a state individual mandate, which according to the state Dept. of Banking and Insurance reduced requested rate increases by about 7%.  Taken together, the mandate and reinsurance program will push 2019 premiums more than 20% below where they would have been absent these two programs and down an average of about 9% from this year. That in the wake of average increases of 22% for 2018.

It's worth tallying the various ways New Jersey has girded its individual market against Republican sabotage.  The state
  • Enacted a state individual mandate modeled on the ACA mandate that Republicans zeroed out last December.
  • Obtained federal pass-through funding for a reinsurance program designed to reduce premiums by 15% -- also funded in part by revenue from the state individual mandate.
  • Bans the lightly regulated, medically underwritten short-term health plans that the Trump administration has unleashed to undermine the ACA-compliant market.
  • Checked the administration's loosening of the rules for association health plans via the individual mandate bill, with a provision requiring small business employees to obtain small group insurance to fulfill the mandate.
  • Instructed health insurers in the individual market to "silver load" the cost of CSR and encouraged them to offer silver plans free of the CSR load off-exchange.
  • Instructed all state agencies to promote enrollment for 2019.
These measures are sorely needed, as total individual market enrollment in New Jersey was down 11% from the first quarter of 2017 to Q1 2018.

Re-upping is a compendium of my posts and articles on this front, as well as outside efforts with BlueWaveNJ and the NJ for Health Care Coalition that I've been involved in. 

Sabotage judo: States can turn individual mandate repeal to their advantage (12/14/18)
Impose a mandate and use the revenue to help fund reinsurance

How Gov. Murphy can protect NJ from Obamacare sabotage (NJ Spotlight, 1/17/18)
Specifics for New Jersey -- e.g. death spirals past

New Jersey bill aims to block Trump's proposed rule for Association Health Plans (3/3/18)
The mandate bill requires small group coverage for small biz employees

BlueWaveNJ testimony in support of individual mandate and reinsurance bills (3/8/18)
Highlights experience of individual market enrollees paying full freight

NJ is poised to fight off ACA sabotage: Is Gov. Murphy aboard? (NJ Spotlight, 3/10/18)
The delay was getting worrisome

NJ for Health Care Coalition letter urging governor's signature on mandate/reinsurance bills (5/30/18)
Addresses financial concerns as well as need for individual market relief

Time for New Jersey's health insurers to help counter Trump sabaotage (NJ Spotlight, 7/16/18)
Calls on insurers to maximize silver loading to offer silver plan discounts off-exchange

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