On Monday, the Centers for Medicare and Medicaid Services issued its final “2019 Payment Notice” rule in a 523-page report, which CMS said would “improve program integrity, increase state flexibility, and reduce regulatory burdens.” This, of course, is all code for “make America’s bad healthcare system even worse.”
“Too many Americans are facing skyrocketing premiums that they can’t afford and every year consumers are faced with the threat of fewer choices,” CMS Administrator Seema Verma said in a statement. “This rule gives states new tools to stabilize their health insurance markets and empower citizens to find coverage that fits their families’ needs and budgets.” Her predecessor, former CMS acting director and United States of Care founder Andy Slavitt, said the new rule was “an effort to create a very different vision that looks like [the healthcare system in] 2007.”
First off: the new rule creates more “hardship exemptions” from the personal mandate of the Affordable Care Act. One such “hardship” is defined as being anti-abortion and living in a place where the only insurers cover abortion as a benefit. Last year’s tax bill repealed the individual mandate completely, which the Congressional Budget Office said would raise premiums by about 10 percent per year in the 2020s, as well as provide health insurance to 13 million fewer people by 2027. How’s that for “skyrocketing premiums”?
Another major change involves essential health benefits, which insurers are required by law to provide, including prescription drugs and maternity and newborn care. While the new rule didn’t technically destroy this function of the law, the Washington Post notes that it “will enable states to allow fewer doctors visits, for example, or to cover fewer prescription drugs.” Those seem pretty important!
Finally, the Post notes that “insurers no longer will be required to devote 80 percent of their income to customers’ care, if they can show that a higher profile would improve their financial stability.” The new rule also raises the threshold for insurers to justify premium spikes from 10 percent to 15 percent. If there’s anything that healthcare in this country needs more of, it’s bigger profit margins for insurers.
But despite this most recent setback, Slavitt stressed that the ACA continues to weather the worst attacks on it:
How long that’ll last is anyone’s guess. Single payer now, please.