Wisconsin, Maine Receive Waivers to Implement Reinsurance Programs

The departments of Health and Human Services and the Treasury have approved Section 1332 waivers for Wisconsin and Maine to implement five-year reinsurance programs for their individual health insurance markets beginning in 2019. The waivers are expected to lower premiums by about 11% in Wisconsin and 9% in Maine in 2019 and increase enrollment in coverage. Under Section 1332 of the Affordable Care Act, states can apply for a waiver of certain ACA requirements but must demonstrate that the proposed waiver would provide access to quality health care that is at least as comprehensive and affordable as without the waiver, and coverage to at least a comparable number of residents. HHS last year approved similar waivers for Oregon, Minnesota and Alaska. The ACA’s transitional reinsurance program to protect health plans in the individual market from unexpectedly high-cost enrollees under the law’s new insurance rules expired in 2016. AHA has encouraged the administration to approve state efforts to stabilize the health insurance marketplaces, and has urged Congress to create a federal reinsurance program and provide multi-year funding for cost-sharing reduction benefits to reduce premiums and stabilize the individual market for 2019 and beyond.