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Aetna’s weekly healthcare update 12/23/2013

Health Reform Weekly

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.


Week of December 23, 2013

The Obama administration announced last week another change in how health coverage under the Affordable Care Act (ACA) will be administered in the coming months. This latest change would allow those whose plans were cancelled or not renewed to buy catastrophic insurance coverage – if available in the individual’s area – instead of meeting the full requirements of the ACA in 2014.  The proposal is the latest in a series of fixes designed to address the President’s “keep what you have” promise. President Obama proposed in November that insurers be allowed to continue offering expiring plans for next year even if they don’t meet the ACA’s new benefits standards, a proposal that only some states are allowing to move forward. The health insurance trade association, America’s Health Insurance Plans, said last week that the latest change could adversely impact the stability of the marketplace and open the door to many individuals seeking the exemption. Under the ACA, catastrophic coverage was to be available only to individuals ages 20-30 with a hardship exemption.

Also, AHIP announced last week that health plans are
voluntarily extending the deadline for payment of first-month premiums for plans purchased through an exchange or marketplace.  Consumers who select their plans by December 23 and pay the first month’s premium by January 10 will be able to have coverage retroactive to January 1.

Because of the holidays, the next edition of Health Reform Weekly will not appear until the week of January 6, 2014.


The Senate voted 64 to 36 last week to approve the “Bipartisan Budget Act of 2013.”  Approved by the House a week earlier, the bill is now ready to be signed into law.
 The core provisions of the budget act is expected to result in $85 billion in budget savings from an assortment of legislative provisions, including an extension of the sequestration cuts to certain mandatory spending programs for two additional years (2022-2023). The act would establish overall spending levels for discretionary funding for fiscal year 2014 (a $44.8 billion increase over current law) and fiscal year 2015 (an $18.5 billion increase), providing relief from a portion of the sequestration cuts that otherwise would be imposed on discretionary spending programs over the next two years.

Other provisions would provide a three-month “patch” to the Medicare provide funding (SGR) formula, establishing a 0.5 percent update from January 1 through March 31, 2014
; provide a one-year extension of both Special Needs Plans (SNPs) and authority for Medicare Cost Plans to continue to operate; and provide a three-month extension of both the Qualifying Individual (QI) program for low-income Medicare beneficiaries and the Transitional Medical Assistance (TMA) program for low-income Medicaid enrollees who are transitioning into employment. The spending caps established by this legislation would allow the House and Senate Appropriations Committees to move ahead with an omnibus spending bill to complete the annual appropriations process for fiscal year 2014.