Washington, D.C., August 1, 2019 -- A Congressional Review Act (CRA) resolution that would overturn guidance from the Centers for Medicare and Medicaid Services (CMS) permitting states to undermine patient protections in the Affordable Care Act (ACA) was introduced in the Senate yesterday. The House version is scheduled to be introduced tomorrow.
Section 1332 of the ACA allows states to waive specific requirements if they meet four statutory guardrails: coverage must be as affordable as it would be without the waiver; coverage must be as comprehensive as it would be without the waiver; a comparable number of people must be covered under the waiver as would be without it; and the waiver must not add to the federal deficit.
This guidance, issued by CMS in 2018, would allow states to restructure their insurance marketplaces in ways that would ease the way to use federal taxpayer dollars to promote substandard plans that do not provide comprehensive and affordable coverage.
The American Heart Association released the following statement in response to the resolutions:
“The CMS guidance would allow states to undermine critical protections for millions of Americans living with pre-existing conditions by enabling the sale of cheap, inadequate health insurance plans alongside high-quality, ACA-compliant options – leading to consumer confusion and market bifurcation. The substandard plans could penalize individuals with pre-existing conditions with premiums based on health status, lack of comprehensive care or even outright denial of coverage.
“We applaud lawmakers for taking this important step to protect patients from substandard insurance products, and we urge Congress to support it.”
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