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News
2-23-12 Affordable Care Act Update
February 24, 2012
Federal Update
Pre-Existing Condition Insurance Plan Covers Nearly 50,000
The Department of Health and Human Services (HHS) released a report today showing that Pre-Existing Condition Insurance Plans (PCIP) are providing health coverage to nearly 50,000 people with high-risk pre-existing conditions nationwide. The PCIP was created under the Affordable Care Act to provide access to quality, affordable health care to people in every state with pre-existing conditions such as cancer who have gone uninsured for six months or more. The program is temporary and unable to serve all in need, but it does serve as an important first step to unlocking the health care system for people with pre-existing conditions. In 27 states, a state or nonprofit entity elected to administer PCIP, while HHS operates the program in the remaining 23 states and the District of Columbia.
ACS CAN strongly advocated to include this provision in the law so that uninsured people with a history of cancer have an option to get the care they need. Recently ACS CAN hosted a webinar for staff nationwide on PCIP. HHS officials led the session, explaining how the program works and what organizations like the Society and ACS CAN can do to ensure that eligible patients are aware of this option. Read the ACS CAN blog post from yesterday for more on PCIP.
CO-OP Loans Awarded
This week, the Centers for Medicare and Medicaid Services (CMS) announced that seven Consumer Oriented and Operated Plans (CO-OPs) will receive government loans to help them establish private non-profit, consumer-governed health insurance companies. Created by the Affordable Care Act, CO-OPs are private, non-profit health insurers designed to provide more competition and choice to consumers by offering quality, affordable health plans in every state through the exchanges. With boards made up primarily of plan members, CO-OPs were created to be more accountable to plan participants and can be more responsive to participants’ specific health care needs. CO-OPs must meet state and federal standards for qualified health plans in order to sell coverage through the exchanges and a state's Small Business Health Options Program (SHOP exchanges). The CO-OP loans were awarded on a competitive basis, with decisions made based on objective reviews performed by external and independent experts. CMS officials with private insurance expertise also had to approve the loans.
Medicaid and CHIP Waivers
HHS issued a final rule this week on demonstration projects in the Medicaid program (so-called “section 1115 waivers”). Demonstration projects have long been permissible in Medicaid and the Children’s Health Insurance Program (CHIP). The Affordable Care Act expands the options and simplifies the process for approving waivers. The final regulation clarifies the new requirements and processes for states requesting new waivers for Medicaid or CHIP and ensures a consistent and timely public comment period for all states.
State Update
On Wednesday, HHS announced a new round of grants to help states establish insurance exchanges. A total of $229 will be allocated to 10 states -- Arkansas ($7.6 million); Colorado ($17.9 million); Kentucky ($57.9 million); Minnesota ($26.1 million); Nevada ($15.3 million); New Jersey ($7.6 million); New York ($48.5 million); Pennsylvania ($33.8 million); and Tennessee ($2.2 million). In its announcement, HHS noted that the latest round of grants brings the number of states making significant progress in creating exchanges to 33.
HHS also announced a final rule for state innovation waivers this week. Under the Affordable Care Act, states can request waivers from the law’s requirements if certain conditions are met. The regulation lays out the procedures states must follow to request waivers. Although the rule is final, states must wait until 2017 before they can apply, unless Congress amends the law. .
Litigation Update
On Wednesday, the Supreme Court announced that it would add an additional 30 minutes for oral arguments to the cases surrounding the Affordable Care Act. The additional time will be dedicated to issues surrounding the Anti-Injunction Act, which bars lawsuits from being brought before a tax is levied. Six hours of the Court’s time is now dedicated to oral arguments on the case, which is unprecedented for the Court in the modern era. Arguments are scheduled for March 26-28, with a decision expected prior to the Court’s adjournment for the summer.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.