December 2018

Even though the end of the year is near, last week was not a slow news week. Late Friday the 14th, a federal district judge in Texas issued a highly anticipated decision in Texas v. Azar, ruling that the Affordable Care Act’s (ACA) individual mandate to maintain health coverage is unconstitutional, and as a result the entire ACA is unconstitutional. Despite the ruling, the ACA is still the law of the land and most legal experts agree that this is only the first step in what is likely to be a long legal road that may end in the Supreme Court; consumers should be assured that if they enroll now they will have coverage in 2019. Heather Howard answers some burning questions related to the ruling and its implications in the latest Woodrow Wilson School Reacts post.

Friday was the very last day of open enrollment for HealthCare.gov and we are saw a big push by states as they remind residents of the deadline to sign up for health insurance. As of the enrollment numbers released last week, 4.13 million people have signed up for plans through HealthCare.gov as of December 8, of which 1.1 million are new consumers.

As we enter the last week of open enrollment for states operating health insurance marketplaces through healthcare.gov, the Centers for Medicaid & Medicare Services (CMS) released their weekly enrollment snapshot for week five. To date, nearly 3.2 million people have selected plans, of which 812,263 are new consumers; this is down from the 3.6 million people who had selected plans by this time last year. While there are many potential drivers of lower enrollment, we will likely have to wait till the dust settles on this open enrollment period to better understand the dynamics. However, as profiled below, several states that run their own state-based exchanges, and have extended open enrollments, are seeing sign-ups that are higher than last year.

Section 1332 waivers were in the health care policy news spotlight this week. On Thursday, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the release of four waiver concepts designed to illustrate how states can waive certain Affordable Care Act provisions under Section 1332 of the law. For more information about the four waiver concepts, see this CMS fact sheet and a discussion paper, which describes each concept in detail. Manatt Health have written an Expert Perspective for State Health and Value Strategies on the new waiver concepts that breaks down the potential new options for states. Updates follow.