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States gear up for the PPACA reboot year

By Allison Bell

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State health insurance regulators and exchange managers are starting to think harder about how to change everything, even if the Patient Protection and Affordable Care Act (PPACA) stays in place.

See also: With PPACA in peril, government offers scant relief

Joel Ario, a former state insurance commissioner and the first head of PPACA exchange regulation at the U.S. Department of Health and Human Services (HHS), is now working at Manatt Health Solutions, the health insurance advisory arm of a big law firm.

Ario and other colleagues at Manatt have prepared a slidedeck that shows policymakers how states can use the PPACA Section 1332 state innovation waiver provisions. The provisions let states ask HHS and the U.S. Treasury Department for PPACA waivers. Waivers could take effect as early as Jan. 1, 2017.

See also: PPACA contains possible PPACA 2.0 provision

The policy committee at the Connect for Health Colorado public exchange board has posted a copy of the slidedeck on their section of the board’s website.

For a look at some of the Section 1332 PPACA reboot parameters, as seen by Manatt PPACA specialists, read on.

Erasing a blackboard

What states can change through the waiver process:

  • The PPACA “shared responsibility” individual mandate.

  • The employer mandate.

  • Health plan benefits design requirements.

  • The current premium tax credit allocation system.

  • The requirement that consumers buy a health plan certified by a PPACA public exchange — a qualified health plan — to get PPACA premium tax credits and cost-sharing reduction aid.

See also: PPACA: HHS Officials Unveil Flexibility Details 

Stone wall

What’s probably cast in PPACA stone 

  • Rules that require insurers to sell coverage without use of information about personal health status other than age and location.

  • Rules that protect consumers against higher out-of-pocket spending limits than those included in the current PPACA rules.

  • Rules that require coverage to be at least as comprehensive as the kind of coverage designed using the current mandates.

  • Any provisions that hold down federal spending. State PPACA rule waiver programs cannot increase the federal deficit.

See also: Obama Backs Wyden-Brown Flexibility Proposal