Med Page Today – by David Pittman
Roughly half of the states are allowing health plans that do not conform to Affordable Care Act requirements to continue in 2014, following concerns that insurance companies were canceling policies for untold numbers of consumers.
At least 19 states intend to allow people with policies canceled as a result of ACA regulations to renew them, according to researchers at the Commonwealth Fund. However, 18 states and the District of Columbia have stated they will not implement the policy fix announced by President Obama last month.
Obama — in response to widespread complaints of canceled policies — called for those consumers who had received cancellation notices to have their policies reinstated in 2014.
Health insurers began sending cancellation notices this fall to consumers who held polices that weren’t compliant with the mandated conditions of the ACA. The cancellation notices drew complaints that Obama lied or at least deceived consumers in 2009 and 2010 when — in trying to rally public support for the law — he told the public if they liked their health plan, they could keep it if the law was passed.
Regardless, not every state is acceding to Obama’s request for canceled policies to continue. Taking up the president’s suggestion was encouraged, but not required.
A large number of states — Alaska, Arkansas, California, Colorado, Connecticut, Indiana, Maryland, Massachusetts, Minnesota, Nebraska, New York, Oklahoma, Oregon, Rhode Island, Vermont, Virginia, Washington, and West Virginia — along with Washington, D.C., have announced they won’t implement the policy fix, according to a blog post from Kevin Lucia, JD, MPH, Katie Keith, JD, MPH, and Sabrina Corlette, JD.
“Of these, the states running their own state-based health insurance marketplace were among the quickest to reach a decision,” the authors wrote. Some states noted concerns such as administrative obstacles, consumer confusion, and potential increases in premiums.
Delaware, Florida, Illinois, Michigan, Missouri, New Hampshire, North Carolina, North Dakota, Pennsylvania, South Carolina, Tennessee, and Wisconsin have publicly stated that they plan to adopt the fix. Kentucky and Hawaii — both of which run their own state marketplace, or exchange, under the ACA — support the fix. Alabama, Kansas, Ohio, Texas, and Wyoming also likely support the canceled health plans’ continuation, the authors wrote.
The Commonwealth Fund research didn’t mention the other states.
“Along with concerns about the success of the marketplaces, a key consideration for state officials is whether they have the legal authority to allow or prohibit the policy fix,” they stated. “Many states also passed their own laws applying some or all of the Affordable Care Act’s market reforms to coverage issued or renewed in their state on or after Jan. 1, 2014. These market reforms include the coverage of a minimum set of essential health benefits and the ban on pre-existing condition exclusions.”
Among states that have adopted new state laws, it is unclear how they will be applied, the authors stated.
“As we have seen throughout implementation of the ACA’s insurance market reforms, the rubber meets the road in the states,” they wrote. “Whether the policy fix meets its stated goals and allows consumers to keep their policies with minimal market disruption largely depends on the decisions — and legal authority — of state officials and whether insurers voluntarily decide to reissue canceled policies.”