Apr 19, 2019

Trump administration releases 2020 ACA rules

Photo: Drew Angerer/Getty Images

Insurers will still be allowed to "silver load" on the individual market next year, the Trump administration announced yesterday.

Why it matters: Silver loading was insurers' solution to the administration's decision to cancel the Affordable Care Act's cost-sharing subsidies for low-income enrollees. It essentially keeps insurers from losing money without raising the financial contribution from subsidized enrollees.

The backdrop: There'd been concern that the administration would ban the practice, and it asked for comments on the change, but "it's good news for consumers that the Administration is not implementing" it, Avalere's Chris Sloan said.

  • The administration also declined to end automatic re-enrollment, which was estimated to lead to lower enrollment and higher premiums.

What else: The administration's rule does allow insurers to use "copay accumulators," which exclude drug manufacturer cost-sharing assistance from counting toward patients' out-of-pocket maximums.

Yes, but: This cost-sharing assistance wouldn't be counted when a patient is taking a branded drug for which its generic is available, which is "likely to drive higher generic utilization," Sloan said.

Go deeper ... Trump: No GOP healthcare replacement of ACA until after 2020 elections

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 4 p.m. ET: 1,252,265 — Total deaths: 68,413 — Total recoveries: 258,495Map.
  2. U.S.: Total confirmed cases as of 4 p.m. ET: 325,185 — Total deaths: 9.267 — Total recoveries: 16,820Map.
  3. Public health latest: CDC launches national trackers and recommends face coverings in public. Federal government will cover costs of COVID-19 treatment for uninsured. Surgeon general says this week will be "our Pearl Harbor, our 9/11 moment."
  4. 2020 latest: "We have no contingency plan," Trump said on the 2020 Republican National Convention. Biden says DNC may have to hold virtual convention.
  5. States updates: New York Gov. Andrew Cuomo said the state is "literally going day-to-day" with supplies.
  6. Work update: Queen Elizabeth II urges the British people to confront pandemic with "self-discipline" and "resolve" in rare televised address.
  7. What should I do? Pets, moving and personal health. Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  8. Other resources: CDC on how to avoid the virus, what to do if you get it.

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Queen Elizabeth addresses U.K. amid coronavirus crisis: "We will meet again"

In a rare televised address on Sunday, Queen Elizabeth II urged the United Kingdom to respond to the coronavirus pandemic with the "self-discipline" and "resolve" that have defined the British people in moments of crisis.

Why it matters: It's just the fifth time that the queen, who traditionally speaks to the nation once a year on Christmas Day, has addressed the British people in this way during her 68-year reign.

Go deeperArrow23 mins ago - World

Cuomo says New York is "literally going day-to-day with our supplies"

New York Gov. Andrew Cuomo said in a press conference on Sunday that New York is struggling to maintain medical supplies while combatting the novel coronavirus — operating "literally" on a "day-to-day" basis.

Why it matters: New York City has become an epicenter of the coronavirus outbreak, facing mass quarantines and stay-at-home orders. Cuomo said Saturday that New York reported 630 new deaths in 24 hours — an "all-time increase" that beat the previous day's record of 562 deaths.