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CLINICAL ROLE -

Community/Retail
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Article

March 9, 2018

Trending News Today: ACA Premiums Could Jump Up to 90% by 2021

Author(s):

AJPB staff

Top news of the day from across the health care landscape.

The Trump administration on Thursday blocked efforts by Idaho lawmakers to circumvent certain aspects of the Affordable Care Act (ACA), The New York Times reported. The state was attempting to allow the sale of stripped-down, low-cost health plans that violate the Affordable Care Act. In a letter to Idaho Governor C. L. Otter, Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma said the ACA, “remains the law, and we have a duty to enforce and uphold the law,” according to the Times. The scaled-back plans Idaho was attempting to allow included charging people more based on individual health history and not covering certain health needs, such as maternity care. Verma told Idaho legislators that the move would force CMS to enforce the ACA provisions, which could include rescinding regulatory authority from the state Department of Insurance and fining insurers $100 per day for each individual insured on a noncompliant plan, according to the Times.

Premium costs for ACA health plans could increase by 90% over the next 3 years, according to The Washington Post. The analysis conducted by Covered California, the state’s insurance marketplace, found that premiums across the country could jump anywhere from 35% to 94% as a result of recent federal decisions. The report noted that a broad portion of Southern states and parts of the Midwest could experience “catastrophic” average rate increases by 2021, according to the Post. "The middle class will be priced out of insurance in about a third of America," Peter Lee, executive director of Covered California, said in the report.

This week’s announcement of Cigna’s acquisition of Express Scripts is further proof that consolidation is necessary in the new era of health care, according to The Wall Street Journal. With integrated services becoming necessary to reduce costs, the combined company will merge Cigna’s insurance assets with the pharmacy benefit management (PBM) services of Express Scripts to remain competitive with UnitedHealth and CVS Health, the Journal reported. Bloomberg reported that the merger is a “best-case scenario” for Express Scripts investors, as PBMs are becoming increasingly scrutinized for their role in high drug costs.

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