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

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? • Anticipated Shared Responsibility Payment revenue impact • Q&A 2

RHODE ISLAND MARKET STABILITY WORKGROUP CHARGE Guiding Principles : Goal : Identify and propose sensible, state-based policy options for 1. Sustain a balanced risk Rhode Island that will be in service pool; to those Principles. 2. Maintain a market that is attractive to carriers, Membership: A diverse group of stakeholders including all Rhode consumers and providers; Island payers, providers, hospital and and medical societies, legislators, consumer advocates, nonprofit 3. Protect coverage gains leaders and brokers. achieved under the Affordable Care Act. 3

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 4

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 opportunities 5

ANTICIPATED SHARED RESPONSIBILITY PAYMENT REVENUE The Shared Responsibility Payment, as currently structured could generate ~$10.6 M in 2020. RI Shared Responsibility Payment Revenue ($M) Rhode Island Uninsured Rate $10.6 $8.6 11.6% $4.3 7.4% 5.7% 2014 2015 2016 4.3% 4.6% $95/person or $325/person or $695/person or Amount is Larger o f: 1% of income 2% of income 2.5% of income # RI returns with 23,540 21,320 16,320 penalty 2013 2014 2015 2016 2017 % of RI returns 4.5% 4.0% 3.1% Note: Assumes enrollment/uninsured rate stays at current levels. 6 Sources: U.S. Census; Rhode Island Market Stability Workgroup (10/16/18); Faulkner Consulting Group

QUESTIONS? 7

Have questions? Email me at Zachary.Sherman@exchange.ri.gov or visit www.HealthSourceRI.com/market-stability- workgroup 8