Health Plan Weekly

New rules that allow immigration officials to consider use of Medicaid coverage and other non-cash benefits in considering whether to approve applications for legal residence are likely to cause a chilling effect on Medicaid enrollment, with the impact spilling over to utilization of other health programs and services, even among family members not directly affected by the rules. Medicaid health plans’ front-line staff members can help with messaging — but the nuances are tricky and communications must be carefully managed, experts say.

The Inadmissibility on Public Charge Grounds final rule was issued by the Department of Homeland Security (DHS) on Aug. 14, 2019. But after several states sued the Trump administration over the rule, preliminary injunctions prevented the regulation from taking effect last year. The Supreme Court on Jan. 27 ruled that the rule could take effect on Feb. 24 in every state but Illinois while litigation works its way through the courts.

✦ The legal dispute between Cigna Corp. and Anthem, Inc. — concerning the $1.85 billion breakup fee tied to their failed attempt to combine — is not going to be resolved as soon as anticipated. Cigna Corp. CEO David Cordani said during the company’s recent fourth-quarter earnings call that he expected a court ruling by the end of February, but a Feb. 14 Securities and Exchange Commission filing from Cigna revealed that the court issued a letter requesting that the parties in the case submit supplemental briefings. “As a result, Cigna Corporation no longer expects the court to issue its post-trial decision in this litigation before the end of February 2020,” the filing states. It did not reveal when a decision now might be expected. View the filing at https://bit.ly/2V7qLXI.

✦ While many employers are interested in taking advantage of the new federal rule that gives them more freedom to offer pretax reimbursement to employees who buy their own health coverage, uptake has been slow. Such is the conclusion of a Modern Healthcare article, which included input from third-party administrators, brokers and health insurers about health reimbursement arrangements (HRAs). Meanwhile, a new report on qualified small employer HRAs (which existed before the new regulations) found that the allowance caps set by the Internal Revenue Service for QSHRAs appear to be at a reasonable level. The report, from the software company PeopleKeep, found just 18% of single employees used up their total allowed funds in 2019 and 19% of families used their allowed funds, according to an article from Benefits Pro. Visit https://bit.ly/39G0Ha2 and https://bit.ly/2P7EXMo.

While Nevada is taking stock of its first Affordable Care Act (ACA) open enrollment period as a true state-based exchange (HPW 2/10/20, p. 4), Pennsylvania is gearing up to follow in the silver state’s footsteps and make its own break with HealthCare.gov.

Pennsylvania is one of three states — alongside New Jersey and New Mexico — that are planning an imminent transition from the federal health insurance enrollment platform to their own state-based exchange. Other states are reportedly considering similar moves now that the dust has long settled from some states’ botched exchange rollouts in the early years of the ACA.

A new study by the Health Care Cost Institute (HCCI) found that the cost of health care and spending on health care both increased dramatically between the start of 2014 and the end of 2018. According to the study, price increases for provider services are the main reason why.

Annual spending per person increased 18.4% over the five-year period, from $4,978 to $5,892, the study said. After figures are adjusted for inflation, the cost of care per person increased by $610 over those five years. While utilization did increase, growing by 3.1% across all billing categories including drug benefits, provider price increases drove about 75% of spending growth — an average of $453 per person — when inflation is taken into account.