Thomas Price, the Affordable Care Act critic who now serves as Health and Human Services secretary, is trying to make creative reuse of an ACA program.
Price is encouraging states to use the ACA Section 1332 state innovation waiver program to get permission to set up high-risk pools, reinsurance programs and other programs to try to stabilize the commercial health insurance market.
The U.S. Department of Health and Human Services and the Treasury Department will try to find money to help pay part of the cost of high-risk pools and reinsurance programs, Price writes in a letter addressed to governors.
“The amount of funding available will depend on state-specific circumstances,” Price writes.
HHS will do what it can to expedite application reviews, Price adds.
A high-risk pool is a special, subsidized insurance program for people with serious, expensive-to-treat health problems.
A reinsurance program is an arrangement that protects an insurer against catastrophic claims, or catastrophic claim totals.
ACA Section 1332 is a provision in the health law that lets a state apply for HHS permission to change how it implements the ACA, within statutory boundaries. A waiver program must, for example, provide access to quality health care that’s at least as affordable as the access that would be provided without the waiver program.
Hawaii, for example, recently received Obama administration permission to give up on its poorly functioning ACA small-group exchange program. The state went back to offering small employers a small-group premium subsidy fund.
In the letter to governors, Price appears to comply with the Section 1332 guidelines established by Obama administration officials, as well as ACA requirements, but he says he will try to provide more flexibility and opportunities for innovation.
That focus on flexibility is in accord with President Donald Trump’s executive order directing agencies to do what they can to lighten ACA-related burdens, Price says.
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