This bill — known as the Bipartisan Market Stabilization and Innovation Act of 2017 — to stabilize the individual health insurance marketplace and enact reforms aimed at bringing down healthcare costs. It would fund Cost Sharing Reduction (CSR) payments which help low- and middle-income families afford healthcare expenses, create a $115 billion fund for states to stabilize the health insurance marketplace, streamline state innovation waivers, repeal the medical device tax, and modify the employer mandate so it impacts fewer small businesses.
Congress would be given clear authority to appropriate funds for CSR payments, and the Dept. of Health and Human Services (HHS) would be required to report to Congress on:
How much is being paid each year;
The effects of such payments on the costs of health insurance in the individual market;
Projected costs of health insurance in the individual market over the subsequent year.
A Patient and State Stability Fund would provide $115 billion over 10 years beginning in 2019 ($11.5 billion annually) to backstop high-cost health claims for patients. States could use the funds to help patients enroll in coverage, reduce the cost of premiums, reduce out-of-pocket costs, and promote enrollment in the individual and small group markets. States would be required to submit applications detailing their plans to receive funds. If a state doesn’t submit an application, or an application isn’t approved the program will default to a federal backstop, working in conjunction with the state, which will reimburse insurers for patients with especially high medical claims.
Section 1332 State Innovation Waivers would be made more efficient by:
Allowing states to access the full amount of federal savings that would be realized via an approved waiver. (States currently only get the savings from reduced spending on premium tax credits and CSRs.)
Shortening the approval window for a 1332 waiver from 180 days to 90 days for standard applications.
Setting a 45-day time limit for 1332 waiver applications filed in response to an urgent situation in areas at risk of excessive premium hikes or having no insurance plans offered, or requests that are materially identical to an already approved waiver.
The employer mandate imposed by the Affordable Care Act (aka Obamacare), which requires businesses with more than 50 employees to offer their full-time workers health insurance or pay a penalty, would be revised so that it’d only apply to businesses with more than 500 full-time employees. Full-time employees would be defined as working at least 40 hours per week, rather than 30 hours per week as under current law.
Other provisions of this bill would:
Repeal the 2.3 percent medical device imposed by Obamacare effective January 1, 2018.
Require HHS to issue regulations within one year to allow Section 1333 Health Choice Compacts between states. (This was required by Obamacare, but HHS never issued the regulations.)
Express that Congress should offset any projected increases to the deficit caused by this bill with policies to negate the projected increase.