THE RHODE ISLAND PRESPECTIVE: A PRESENTATION TO THE OREGON - - PowerPoint PPT Presentation

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Sep 23, 2022 227 likes •321 views

THE RHODE ISLAND PRESPECTIVE: A PRESENTATION TO THE OREGON UNIVERSAL ACCESS TO CARE WORKGROUP By HealthSource RI Director Zach Sherman AGENDA The Rhode Island Market Stability Workgroup Why a state Shared Responsibility Payment?

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THE RHODE ISLAND PRESPECTIVE:

A PRESENTATION TO THE OREGON UNIVERSAL ACCESS TO CARE WORKGROUP

By HealthSource RI Director Zach Sherman

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AGENDA

The Rhode Island Market Stability Workgroup
Why a state Shared Responsibility Payment?
Anticipated Shared Responsibility Payment revenue impact
Q&A

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RHODE ISLAND MARKET STABILITY WORKGROUP CHARGE

Goal: Identify and propose sensible, state-based policy options for Rhode Island that will be in service to those Principles. Membership: A diverse group of stakeholders including all Rhode Island payers, providers, hospital and medical societies, legislators, consumer advocates, nonprofit leaders and brokers.

Guiding Principles:

1. Sustain a balanced risk

pool;

2. Maintain a market that is

attractive to carriers, consumers and providers; and

3. Protect coverage gains

achieved under the Affordable Care Act.

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WORKGROUP RECOMMENDATIONS

Near-term recommendations:

To secure a 1332 waiver under the ACA to implement a

reinsurance program

Garner state authority to regulate Short-Term Limited

Duration (STLD) and other limited benefit health plans

Implement a state-based shared responsibility

requirement Further work remains, including:

Action to determine how to fund a state reinsurance

program and how to best design and implement a shared responsibility requirement

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REASONS TO CONSIDER A STATE SHARED RESPONSIBILITY PROVISION

A state-level Shared Responsibility Payment would:

Incentivize people to get and stay insured
Help stabilize the risk pool, protect against adverse

selection

Generate revenue for affordability programs
Provide data on the uninsured, create outreach
pportunities

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The Shared Responsibility Payment, as currently structured could generate ~$10.6 M in 2020.

ANTICIPATED SHARED RESPONSIBILITY PAYMENT REVENUE

$4.3 $8.6 $10.6

2014 2015 2016

Amount is Larger of: $95/person or 1% of income $325/person or 2% of income $695/person or 2.5% of income # RI returns with penalty 23,540 21,320 16,320 % of RI returns 4.5% 4.0% 3.1%

RI Shared Responsibility Payment Revenue ($M)

Note: Assumes enrollment/uninsured rate stays at current levels.

11.6% 7.4% 5.7% 4.3% 4.6%

2013 2014 2015 2016 2017

Rhode Island Uninsured Rate

Sources: U.S. Census; Rhode Island Market Stability Workgroup (10/16/18); Faulkner Consulting Group

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QUESTIONS?

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