With the passage of the $1.3 trillion Omnibus Spending Bill on Friday, March 23, 2018, a shutdown of the federal government that could have happened that day was averted. However, the bill did not offer any assurance against excessive health insurance premium rate hikes in the future and that threat remains prevalent.
The spending bill contained no provisions to stabilize the health insurance markets. Legislation to restore the Cost Sharing Reduction (CSR) payments to insurers, which were eliminated by the Trump administration last October, would have brought stability to the market and offered some assurance to consumers against high percentage premium hikes in the near future. These payments help low-income Americans afford their co-payments and deductibles. The Omnibus also left out language directing the establishment of re-insurance funds for states. These funds would help cover the cost of people with complex and expensive healthcare needs. Economists widely agree that these two mechanisms are needed to ensure stability in the health insurance exchange markets. Text of the legislation is available online.
The Omnibus bill funds the federal government through September 30, 2018 and adheres to the federal fiscal spending levels agreed to as part of the Bipartisan Budget Act of 2018, which became law in February. (Refer to my Blog Post of March 12, 2018 for more information about that Act.)
Although the insurance stabilizer provisions did not make it into the final legislation, healthcare advocates from the Long Island and Hudson Valley regions are grateful to the members of New York’s delegation who supported the Omnibus Bill because it did include other favorable healthcare provisions such as nearly $4 billion to address the opioid epidemic and $37 billion for the National Institutes of Health. Legislators supporting the Omnibus bill include Senator Charles Schumer and Representatives Peter King, Kathleen Rice, Gregory Meeks, Nita Lowey, and John Faso.
Reinstatement of the CSRs and establishment of a re-insurance fund remain priorities. Healthcare advocates will keep fighting for these so that excessive premium hikes are avoided and patients can continue to afford their health insurance. In a little more than four weeks, May, insurers must submit their proposed 2019 rates to New York State for review. The uncertainty insurers faced all last year about CSR funding prompted most to increase premiums as a way to guard against the loss of CSR funding.