The House considers health policy bills

Lisa Kaplan Howe on February 9, 2017

As debate continues over the future of the Affordable Care Act (ACA), the House has held hearings on four piecemeal bills aimed at making incremental changes to the ACA:
  • The State Age Rating Flexibility Act of 2017 would expand permissible age rating bands to 5:1 (currently 3:1) under the ACA or a different ratio adopted by the state.
  • The Plan Verification and Fairness Act of 2017 would prohibit insurers from making coverage effective for new enrollees who enroll during a special enrollment period (SEP) for plan years beginning on or after January 1, 2018, until the U.S. Department of Health & Human Services (HHS) has verified the individual’s eligibility. This would provide for a process similar to the review and assessment process outlined in the preface to the final Notice of Benefit and Payment Parameters for 2017, but would extend the current pilot to all SEP applications. It is not clear if eligibility determinations would continue to be retroactive. The bill directs HHS to create an SEP eligibility verification process through interim rulemaking.
  • The Health Coverage State Flexibility Act of 2017 would reduce the current 90-day grace period for those individuals receiving Advanced Premium Tax Credits (APTC) who miss premium payments to the time period established by state law, or one month for plan years beginning in 2018.
  • The Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017 would maintain—though in a more limited manner than under the ACA—a ban of preexisting condition clauses and a requirement for guaranteed availability in the individual and group markets if the ACA is repealed and prior law is restored. Underwriting of premiums would be allowed and it appears that there would be a continuous coverage requirement to be eligible for these protections.

Published by Lisa Kaplan Howe

Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News. Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.

  1. Roundup of federal health policy developments – Health Policy News Blog July 12, 2018 at 10:13 pm

    […] Read more about these four House bills here. […]

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