Some reading for policy wonks on the Affordable Care Act regulations released on Tuesday


Posted by AzBlueMeanie:

Ezra Klein's Wonkblog at the Washington Post offers a series of posts in a summary of the Affordable Care Act regulations released on Tuesday. This should give you policy wonks something to read over the long Thanksgiving Day weekend. Wonkbook: Everything you need to know about Obamacare’s regulations:

Everything you need to know about Obamacare’s regulations

The Affordable Care Act regulations came down on Tuesday. Here’s what they say.
“The Obama administration took a big step on Tuesday to carry out the
new health care law by defining ‘essential health benefits’ that must be
offered to most Americans… Insurance companies are rushing to devise
health benefit plans that comply with the federal standards. Starting in
October, people can enroll in the new plans, for coverage that begins
on Jan. 1, 2014…The rules lay out 10 broad categories of essential
health benefits, but allow each state to specify the benefits within
those categories, at least for 2014 and 2015. Thus, the required
benefits will vary from state to state, contrary to what many members of
Congress had assumed when the law was adopted.” Robert Pear in The New York Times.

Read: The health regulations in the Federal Register.

Another key component of the rules includes those on preexisting conditions coverage.
“The Obama administration issued new rules Tuesday that require
insurance companies to cover people with preexisting medical conditions —
one of the most popular provisions of President Obama’s healthcare
law…Covering people with preexisting conditions is expensive, and the
law seeks to bring younger, healthier people into the system to offset
the additional costs of covering sick people. HHS took steps in crafting
the regulations to minimize the potential shock to customers’ premiums.
For example, in the policy governing rate increases based on age, HHS
said rates should increase slightly every year, rather than building in
larger price jumps every five years.” Sam Baker in The Hill.

@sarahkliff: What’s that? You were looking for 112 pages of actuarial value in health exchanges regulations? You, sir, are in luck!

Wellness programs also get a big boost in the ACA regs.
“The Obama administration released new regulations Tuesday to encourage
participation in employer-based wellness programs as a way to drive
down healthcare costs…The less-familiar wellness rules will increase the
maximum permissible reward for workers who participate in programs that
encourage certain health outcomes, such as smoking cessation or weight
loss…Under the proposed rules, these ‘health-contingent wellness
programs’ will now yield a reward of up to 30 percent of the cost of
health coverage rather than 20 percent. Workers involved in smoking
cessation programs will be eligible for as much as a 50 percent
discount, HHS said.” Elise Viebeck in The Hill.

Pre-ex rules: premiums may vary on age, tobacco use, family size &
geography but not on health status, gender or occupation.

3 more ways the Affordable Care Act changed on Tuesday.
“[T]here are a few important changes that the Obama administration made
Tuesday. Culled from the 333 pages of federal regulation, here are the
three most important changes that happened…Higher deductibles are a-okay
— in certain plans…In the small group market, this meant that insurers
could not set a deductible any higher than $2,000 for an
individual…Insurers griped out this provision: They said it might be
impossible, with that relatively small deductible to build an insurance
plan that has the consumer paying 40 percent of the bill. Tuesday, the
Obama administration essentially agreed.” Sarah Kliff in The Washington Post.

@sam_baker: Today’s #hcr regulations give insurers more certainty about some of the ACA’s most politically popular elements [bad link]

What the Affordable Care Act does? Americans just don’t know.
“After surviving a Supreme Court decision and a presidential election,
the Obama administration’s health-care law faces another challenge: a
public largely unaware of major changes that will roll out in the coming
months. States are rushing to decide whether to build their own health
exchanges and the administration is readying final regulations, but a
growing body of research suggests that most low-income Americans who
will become eligible for subsidized insurance have no idea what is
coming…Low enrollment could lead to higher premiums, health policy
experts say. Hospitals worry that, without widespread participation,
they will continue getting stuck with patients’ unpaid medical bills.” Sarah Kliff in The Washington Post.

The states will get extensive input in the health law.
“The Obama administration Tuesday issued new rules to implement several
key provisions of the health-care-overhaul law, giving states some
additional discretion over plans sold within their borders…The federal
government also expanded requirements for prescription-drug coverage
from previous proposals, but it left states with different options to
choose from, as well as responsibility for enforcement.” Louise Radnofsky in The Wall Street Journal.