Health-Exchange-Alert

CMS on Thursday (Jan. 17) released its long-awaited exchange policy regulation, and while it avoided making changes to the silver-loading process, the agency did propose several other policies including allowing mid-year drug formulary changes, creating a new special enrollment period for people newly eligible for subsidies, increasing maximum out-of-pocket spending limits, and reducing the user fee by half of a percentage point.

CMS proposed letting exchange plans change formularies mid-year to speed generic drug uptake, the agency announced Thursday (Jan. 17).

The 2020 Notice of Benefit and Payment Parameters, the crucial rule that will set the requirements for next year’s Affordable Care Act marketplaces, cleared the review at the White House Office of Management and Budget on Wednesday (Jan. 16) and could be published soon.

Insurers tell CMS not to finalize the proposal to separately bill consumers the portion of their premium that goes toward abortion coverage, saying the policy would increase costs far beyond the agency’s estimates, would frustrate consumers and risk plan cancellations, and would be impossible to implement on the proposed timeframe.

Attorney General nominee William Barr in his Tuesday (Jan. 15) confirmation hearing told Sen. Kamala Harris (D-CA) that he is open to reconsidering the Department of Justice’s decision to not fully defend the Affordable Care Act against a constitutional challenge from 20 GOP-led states.

A Pennsylvania district court judge on Monday (Jan. 14) issued a nationwide injunction blocking the implementation of two Trump administration rules that would loosen the Affordable Care Act’s requirements that employers cover contraceptive services by allowing those employers to claim moral or religious exemptions.

House and Senate Democratic leaders continued their expected oversight efforts on Thursday (Jan. 10) by demanding CMS explain why it continues to charge states using the federal technology a user fee of up to 3.5 percent of premiums even as the agency has slashed money for exchange advertising and outreach services that those funds are meant to support.

A Utah lawmaker is pushing to attach work requirements to the state’s newly approved Medicaid expansion, and if the full legislature agrees, the proposal could delay the implementation of that expansion.

As a federal district judge’s ruling to repeal the Affordable Care Act moves through the court system, some House Republicans are taking steps to prevent the case, brought by GOP-led states, from eliminating protections for preexisting conditions.