Monthly Archives:May 2017

BlueCross BlueShield release framework for market stability

24 May , 2017,
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As reported by multiple news sources, the BlueCross BlueShield Association recently released a framework for market stability. This press release was in response to the White House seeking a 90 day delay in the House vs. Price lawsuit. The House vs. Price lawsuit appears to be a central issue for insurers planning to participate in the Health Insurance Marketplace for 2018, as this lawsuit may determine the fate of $7 billion in Federal funding for Cost Sharing Reductions (CSRs) – money used to reduce co-pays, deductibles and out-of-pocket amounts for Americans that fall within certain income parameters. As insurance carriers scramble to file rates for 2018, the availability of CSR funding may be a linchpin for actuaries responsible for determining how much insurers will charge for coverage, or whether some insurers will participate at all in the individual health insurance marketplaces. Below are the key points released by the BlueCross Blueshield Association:

-Continued protections for people with pre-existing medical conditions and sustained federal funding to offset the cost of care for the sickest patients.

-More leeway for states to experiment with health insurance benefits, with a basic floor of federal standards.

-Preserving ACA consumer safeguards including no lifetime caps on benefits, no higher premium for women based on gender, and a requirement that insurers spend a minimum of 80 cents of every premium dollar on medical care.

-Penalties such as waiting periods for people who fail to maintain their coverage. Republicans want to repeal the Obama-era tax penalties on uninsured people deemed able to afford coverage.

-Significant federal funding to subsidize premiums and out-of-pocket costs.