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States can now apply for recently expanded exemptions to create alternatives to the Affordable Care Act program, the Centers for Medicare and Medicaid Services announced Monday. They could use this increased power to determine who receives financial assistance to pay premiums and to change what types of coverage are prioritized in the individual market.
The announcement comes just two weeks before the mid-term elections. Health care is a top priority for Americans, prompting candidates to attack each other to see who would do more to reduce costs and protect people with pre-existing conditions.
The moving Seema Verma, a CMS administrator, will increase affordable insurance options while maintaining coverage for people with pre-existing conditions.
"The guidelines in place previously were really too restrictive and thwarted innovation," Verma said. "We think this version offers this level of flexibility."
She added that the goal of the administration was to "get states out of Obamacare's onerous rules".
Health policy experts, however, immediately responded that this could leave low-income, older, or sicker residents less choice and higher costs while promoting healthy, young people.
The Trump administration has taken repeated measures to weaken Obamacare through lesser regulatory changes, after congressional Republicans failed to repeal the 2010 Health Reform Act, a landmark law, the government said. 39, last year. It has expanded access to two types of insurance policies with lower premiums, but with fewer benefits than those offered by the Affordable Care Act. It has also allowed states to impose new mandates – particularly job requirements – on Medicaid recipients.
Perhaps the most important change that states could make was the recipients of the Obamacare federal bonus grants, which have been critical to maintaining the workforce in recent years. Currently, grants can only be used to buy trade policies and can only go to those earning less than 400% of the poverty line (just over $ 48,500 for a single person or $ 1,000 for a family of four).
However, short-term plans are allowed to exclude people with pre-existing conditions. Advocates of Obamacare are concerned that these plans will divert those with fewer health care needs, increasing the premiums of sicker registrants who remain in the exchanges.
States could also use exemptions to encourage greater coverage among younger, healthier residents, Verma said. The agency will also work with states on options to insure high-cost residents, which could help reduce premiums for all.
The administration has also made some key adjustments to how waivers would be assessed. Applications will now be evaluated based on their impact on the coverage and affordability of residents of the state as a whole, rather than certain groups of people, such as the poor or the sick. It puts the emphasis on "access" to the cover, a privileged Republican discussion topic.
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