Health Plan Weekly

With a law finally passed that extends enhanced Affordable Care Act subsidies for another three years, health insurers and government agencies can now start their consumer-outreach campaigns for the upcoming open enrollment period in earnest. But they’ll also be prepping for a bigger challenge down the road: Ensuring a smooth transition for people who will no longer be covered by Medicaid after the COVID-19 public health emergency (PHE) ends. 

To that end, the Biden administration on Aug. 30 rolled out a plan called the “Assister Strategy to Support Medicaid Unwinding.” As part of that plan, HHS said it’s allocating $100 million to Navigator grantee organizations for the 2022-2023 budget period as well as reviving the Enrollment Assistance Program (EAP), which established temporary storefronts and labor forces that the Obama administration used in the ACA marketplaces’ early years to supplement Navigators’ outreach efforts. For the new version of the EAP, the Biden administration will deploy “mobile assisters” across population centers identified by HHS. 

Employers are beginning to see the value of individual coverage health reimbursement arrangements (ICHRAs), managed care insiders tell AIS Health, a division of MMIT. Brokers and third-party experts say that while uptake has been slow so far, the ICHRA market could take substantive amounts of business away from both self-funded and fully insured commercial insurance books, particularly among medium-sized employers. 

ICHRAs allow employers and employees to purchase Affordable Care Act marketplace plans. Employees select a plan on a health exchange or through a private broker, and their employer reimburses the member each month for a fixed amount of premium. Unlike exchange plans purchased by individuals, exchange plans purchased as part of ICHRA are not subsidized by advance premium tax credits. The market is still in its infancy: ICHRAs were created by the Trump administration in 2019, and the first policies in the segment were sold for the 2020 plan year. 

While a recently proposed rule from HHS would mostly reinstate nondiscrimination protections that the Trump administration unwound, it also addresses an emerging issue that is likely to stir up controversy in the health insurance industry: bias in clinical algorithms. 

The regulation, posted Aug. 4 in the Federal Register, would for the first time at the federal level prohibit a covered entity “from discriminating against any individual on the basis of race, color, national origin, sex, age, or disability through the use of clinical algorithms in decision-making,” explains a July 27 Health Affairs article summarizing the proposal. “Covered entities” include all health programs and activities receiving federal financial assistance, including health insurance issuers that get federal funding.