President & Managing Consultant, Sailer Benefit Services, Inc
All information listed below was obtained from the National Association of Health Underwriters (NAHU) email update, October 12, 2017.
What is in the Executive Order?
The Executive Order directs the Secretary of Labor to consider proposing regulations or revising guidance to expand Association Health Plans. The intent of this directive is to allow employers in the same line of business anywhere in the country to join together to offer healthcare coverage to their employees. It could potentially allow employers to form AHPs through existing organizations, or create new ones for the express purpose of offering group insurance. This could lead to the sale of insurance across state lines through AHPs; however, more action will need to be taken by the Department of Labor before this option can be available.
The EO directs the secretaries of HHS, Treasury, and Labor to consider proposing regulations or revising guidance to expand short-term limited duration insurance (STLDI). This directive would allow the agencies to revisit the rule enacted by the Obama Administration that limited the length of STLDI plans to three months.
The EO directs the secretaries of HHS, Treasury, and Labor to consider proposing regulations or revising guidance to expand Health Reimbursement Arrangements. The intent of this directive is to allow employers to contribute more to their employees' HRAs. HRAs are employer-funded accounts that reimburse employees for healthcare expenses, including deductibles and copayments. The IRS does not count funds contributed to an HRA as taxable income. The intent of this directive is to expand HRAs, which could provide employees with more flexibility in how their healthcare is financed.
What Happens Next?
The EO directs the Secretary of Labor to act within 60 days to consider proposing regulations or revising guidance on AHPs. It also directs the secretaries of Treasury, Labor and HHS to act within 60 days to consider proposing regulations or revising guidance on STLDIs, and for the agencies to act within 120 days to consider changes to HRAs.
Within 180 days, the secretary of HHS, in consultation with the secretaries of Treasury, Labor and the Federal Trade Commission, must report to the President on state and federal laws, regulations and policies that limit healthcare competition and choice, as well as on actions that federal and state governments could take to increase competition and choice and reduce consolidation in healthcare markets.
The EO does not direct the agencies to adopt specific regulations; therefore, in order for any policies to change, the agencies will have to go through the traditional rulemaking procedures of providing a proposed rule for public comment before being able to enact any final rules.
What about Open Enrollment for 2018?
At this time, nothing in the EO will affect open enrollment for 2018 unless regulatory action is taken by the agencies. Until any such regulations are enacted, the ACA and all of its regulations, penalties, and enforcement remain the law of the land.
National Association of Health Underwriters | https://nahu.org/
Gregory S. Sailer
According to the National Association of Health Underwriters, a market stability bill was released last week by Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA). It was formally introduced with 22 bipartisan co-sponsors—11 Republicans and 11 Democrats—and would temporarily fund the ACA’s cost-sharing reduction (CSR) program, provide for greater flexibility for Section 1332 waivers, as well as establish a new “copper-level” plan and provide for additional federal funding for enrollment outreach.
After looking over the draft document, the Alexander-Murray bill does not seem to affect any of the Affordable Care Act’s core elements – like patient protections, tax credits, or essential health benefits.
In summary format, here are the major provisions of the proposed market stability bill:
Restoring of CSR Payments – Intended to restore market stability and affordability
Maintaining the Core Protections of 1332 Waiver Provision – expands “pass-through” payments to states, allows states to propose value-based insurance designs, and adds language to protect vulnerable populations, those with serious health conditions, and low-income people.
Streamlining the 1332 State Waiver Process – Expedites states’ waiver applications, grants Governors the ability to approve state waiver applications, and changes budget assessment
Reinvesting in outreach and enrollment – includes increased funding for outreach, as well as reporting requirements
Expanding eligibility for catastrophic plans – maintains risk pools so those with serious medical needs are not priced out.
Information for this article was obtained from multiple sources, including the National Association of Health Underwriters, Wikipedia's one page summary of the Murray-Alexander Market Stability Bill and the Washington Post's draft copy of the Bill.
Greg Sailer is the President and Managing Consultant for Sailer Benefit Services, an Employee and Executive Benefit Firm in the Twin Cities.
Sailer Benefit Services, Inc. | 651-702-5626 | firstname.lastname@example.org