On Monday, the Centers for Medicare and Medicaid Services (CMS) issued new guidance that would give states more freedom to reform their individual health insurance markets. Since the passage of Obamacare, the number of insurers has plummeted and premiums have skyrocketed. The new rule gives states more flexibility to implement reforms that will reduce health care costs and increase choice and competition, while maintaining consumer protections.
Under Obama-era guidance, states could apply for Section 1332 State Innovation Waivers (SIW) from CMS. If approved, these waivers allowed states to enact several health care reforms. However, the old guidance limited the extent to which states could innovate by strictly interpreting Obamacare statutory guardrails. For example, states had to offer plans at least as comprehensive as would be without the waiver, offer premium and cost-sharing subsidies at least as affordable, maintain coverage to at least a comparable number of residents, and not increase the federal deficit.
In the new guidance, CMS renames SIW as State Relief and Empowerment Waivers. The updated waivers will allow states to introduce innovative coverage options that meet the diverse needs of individuals and families. CMS will reinterpret existing guardrails in a broader manner and grant waivers that accomplish these five goals: Provide increased access to affordable private market coverage, encourage sustainable spending growth, foster state innovation, support and empower those in need, and promote consumer-driven healthcare.
Finally, CMS will permit states to provide access to more insurance options at different price points and benefit levels. Additionally, CMS may allow federal funds to subsidize the purchase of short-term, limited-duration insurance (STLDI) plans or association health plans (AHP) on Obamacare exchanges.
The updated guidance comes a year after President Donald Trump issued an executive order to promote health care choice and competition. This year, the administration has issued new rules to expand eligibility for AHPs and reduce restrictions of STLDI plans.
The Heartland Institute released a press release applauding the new guidance.
“Despite a growing need, increasing costs, and limited providers in dozens of state exchanges, Congress has been unwilling to pass meaningful reform to fix the ACA,” Senior Policy Analyst Matthew Glans wrote. “Fortunately for state policymakers, there is an option available to them to retake control of their health care markets, the waiver process…With this new guidance from [CMS] and the Trump Administration, the training wheels are finally off and states can pursue the kind of systemic reforms that they need to lower the cost of health care and return real choice to consumers.”
What We’re Working On
Energy & Environment
Climate Change Reconsidered II: Fossil Fuels – Summary for Policymakers
In this fifth volume of the Climate Change Reconsidered series, 117 scientists and other experts refute the International Panel on Climate Change’s claim that the impacts of climate change on human well-being and the natural environment justify dramatic reductions in the use of fossil fuels. Climate Change Reconsidered II: Fossil Fuels, produced by the Nongovernmental International Panel on Climate Change, assesses the costs and benefits of the use of fossil fuels by reviewing scientific and economic literature on organic chemistry, climate science, public health, economic history, human security, and theoretical studies based on integrated assessment models and cost-benefit analysis.
Fiscal Analysis Shows Oklahoma Should Embrace Universal School Vouchers
In this Research & Commentary, Policy Analyst Tim Benson analyzes a new EdChoice report that revealed Oklahoma’s Lindsey Nicole Henry Scholarships for Students with Disabilities voucher program has generated cumulative net savings for state and local budgets of $3.2 million since it was enacted in 2010. This equates to $3,200 saved per voucher student. Additionally, fiscal analyses of voucher programs in the country have determined that voucher programs produce no additional burden on taxpayers.
Shrinking Insurance With Skinny Plans (Guest: Chris Pope)
In this episode of the Heartland Daily Podcast, Chris Pope, senior fellow at the Manhattan Institute, sits down with Health Care News Managing Editor Sarah Lee to discuss short-term, limited-duration health insurance plans and how some liberal-leaning organizations are finally admitting these plans widely benefit all consumers.
Budget & Tax
‘Clean House’ Will Eliminate Unnecessary Regulations
In this Research & Commentary, Senior Policy Analyst Matthew Glans discusses Arkansas‘ efforts to streamline its redundant and onerous regulatory system and how the Natural State could be a model for other states. Glans recommends states implement a REINS Act paired with a Housecleaning Bill to give lawmakers the tools to cut back the size, scope, and power of government.
From Our Free-Market Friends
Election 2018: Platforms, Proposals, Projections
The James Madison Institute recently published a report that analyzes the current political and economic landscape of Florida and how it may change following the outcomes of the midterm election. The Sunshine State’s traditional economic policy agenda of low taxes and reduced regulations has contributed to its residential and commercial boom. The winner of the gubernatorial election will likely determine Florida’s economic trajectory—whether it stays on its positive course or dramatically diverts for the worse.
Click here to subscribe to The Leaflet, the weekly government relations e-newsletter.