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February 11, 2014 at 07:25 AM
Regulators are trying to accommodate existing programs that help sick consumers pay for federal exchange plan coverage without letting new aid programs drive up claims.
Officials at the Center for Consumer Information & Insurance Oversight, an arm of the U.S. Department of Health and Human Services, talk about private premium assistance programs in a new collection of two answers to frequently asked questions.
CCIIO, part of the HHS Centers for Medicare & Medicaid Services, supervises all Patient Protection and Affordable Care Act exchanges, and it administers the HHS-run exchanges.
In November, CCIIO discouraged private charities and other private “third-party payers” from paying the premiums for consumers who buy private “qualified health plan” exchange coverage.
PPACA itself provides subsidies — premium assistance tax credits — to help moderate-income consumers pay the QHP premiums.
But, if private organizations help people pay the premiums,” that could skew the insurance risk pool, CMS officials said in November.
HHS officials have worried that PPACA rules may already make the exchanges very attractive to sick people and not attractive enough to young, healthy people to hold claim risk to manageable levels.
In the new guidance, CCIIO officials acknowledge that existing programs, such as the federal Ryan White HIV/AIDS program and Indian organization aid programs, already have official federal permission to help some consumers pay for coverage.
