Nov 30, 2018

Trump's new waiver rules take a big swing at the ACA

Photo: Brendan Smialowski/AFP/Getty Images

The Trump administration is using a regulatory workaround to achieve some of the same goals of Republicans' failed efforts to repeal and replace the Affordable Care Act.

Driving the news: HHS released new guidance yesterday about how it will approach the ACA's existing waiver process. It said it would, in some circumstances, approve waivers that go far beyond what's currently allowed.

  • States could change the way the ACA's subsidies are administered. They're currently based on income and the cost of insurance. States could change that to take consumers' age into account — a model that was also used in repeal-and-replace legislation.
  • States obtaining a waiver could also let people use their ACA subsidies to buy insurance that doesn't meet the ACA's coverage requirements — for example, newly expanded "short-term" plans that are able to turn away people with pre-existing conditions.

The big picture: This is one of the administration's most significant anti-ACA moves to date — if it works.

  • States that ask for everything they're now allowed to, and get it, could set up an insurance market that looks a lot different from what the ACA envisioned.
  • But they have to be approved first. Actuaries at the Centers for Medicare & Medicaid Services, who are independent from the agency's political leadership, will have to certify that a waiver wouldn't weaken the state's overall insurance market too badly.

What's next: The new standards and/or any approved waivers could face legal challenges — both on the merits and because these new rules were articulated in a guidance document rather than a formal regulation with opportunities for public comment, Brookings fellow Christen Linke Young writes.

Go deeper: Trump administration loosens rules for ACA waivers

Go deeper

Pandemic and protests can't stop the stock market

Traders work on the floor of the NYSE. Photo: Spencer Platt/Getty Images.

United States equities were on pace to open higher Monday following big gains in Asia and Europe and a risk-on bid in currency markets.

Why it matters: Stock markets could continue to rise despite an unprecedented global pandemic, violent protests over police violence in the U.S. not seen since the 1960s, and spiking tensions between the world's two largest economies.

19 mins ago - Sports

The sports world speaks up about death of George Floyd

Celtics guard Jaylen Brown. Screenshot: Jaylen Brown/Instagram

There was a time when a months-long sports absence would have silenced athletes, leaving them without a platform to reach fans or make their voices heard.

Why it matters: But now that athletes boast massive social media followings and no longer need live game broadcasts or media outlets to reach millions, they're speaking out en masse amid protests over the death of George Floyd and other police-related killings of black people — delivering messages of frustration and unity, despite their leagues not currently operating.

The technology of witnessing brutality

Charging Alabama state troopers pass by fallen demonstrators in Selma on March 7, 1965. Photo: Bettmann/Getty Images

The ways Americans capture and share records of racist violence and police misconduct keep changing, but the pain of the underlying injustices they chronicle remains a stubborn constant.

Driving the news: After George Floyd's death at the hands of Minneapolis police sparked wide protests, Minnesota Gov. Tim Walz said, “Thank God a young person had a camera to video it."