More on Policy and Legislation

Insurers gain from some Senate bill provisions but Medicaid funding remains a top concern

In the short term, there's immediate stability for insurers in the bill's funding for cost-sharing reduction payments through 2018.

Susan Morse, Senior Editor

The Senate's version of a healthcare bill does more to help insurers than providers, though payers remain concerned about cuts to Medicaid and the lack of a mandate for individuals and employers.

In the short term, there's immediate stability for insurers in the bill's funding for cost-sharing reduction payments through 2018.

"There's a lot in this for immediate stability," said Kristine Grow, spokeswoman for America's Health Insurance Plans.

[Also: Senate GOP reveals healthcare bill to repeal and replace Affordable Care Act]

The bill eliminates the hated health insurance tax, which Anthem CEO Joe Swedish partly blamed for the insurer's exit from some markets.

Two different funds also provide stability, Grow said.

The first is a federal fund for reinsurance, which continues through 2021. Reinsurance under the Affordable Care gave payments to plans that enroll higher-cost consumers.

Then there's a long-term stability fund that allows states to implement their own solutions, Grow said.

But issues remain.

"We still need to solve for continuous coverage," she said. "We need to replace the individual mandate with some solution for some coverage."

AHIP does not support the high-risk pool solution to help lower premiums. States would get a waiver so that plans would not have to offer the essential benefits now covered under the ACA.

"We feel strongly everybody should be in the same risk pool," Grow said.

The group representing insurers continues to analyze the bill and is looking to the Congressional Budget Office score due out early next week.

Both insurers and providers are both concerned about funding for Medicaid. As did the House healthcare bill proposal, the Senate bill would turn Medicaid from an entitlement to a block-grant funded program..

The Partnership for Medicaid, a nonpartisan, nationwide coalition of healthcare providers, safety net health plans, and others, said it opposed the changes to Medicaid.

"The changes to the House-passed American Health Care Act made by the Senate will further slash the rate of Medicaid funding provided to states in the long-term," the organization said. "Capping funding will ultimately reduce access to care for beneficiaries, prevent the program from being responsive to unexpected public health and economic challenges, shift costs to states and local governments and drastically reduce payments to providers and plans."

Other differences between the Senate and the House bill are that the latest bill would provide consumer subsidies based on more than age, including cost of coverage.

Insurers would not be allowed to charge higher premiums to those with pre-existing conditions.

The Senate is under a self-imposed deadline to pass the bill prior to the July 4 recess.

Early next week, the Congressional Budget Office is expected to release a score of the bill detailing what it would cost, both financially and in terms of the number of consumers affected.

House Majority Leader Mitch McConnell has yet to get the needed votes within his party to pass the Better Care Reconciliation Act of 2017. At least four conservative Senators including Ted Cruz and Rand Paul, have said they can't support it in its current form because it does not go far enough to dismantle the Affordable Care Act.

Other moderates within the party, such as Senator Susan Collins of Maine, have voiced concern that the bill would increase the cost of plan premium or out-of-pocket costs for older Americans.


Crazy Explosive Boost 2017 PK