How a $1.1 billion Medicare prescription drug deal with Clovis Community College saved the ACA
- by admin
A $1 billion deal between the Medicare program and Clovus Community College, a community college in northeast Ohio, has saved Obamacare’s health insurance marketplaces, according to a new report.
The report from the conservative think tank the Heritage Foundation says that Clovas would have been allowed to stay in the program if it had gone through with the deal.
Clovass, an Ohio-based public school that operates schools and has about 4,400 students, was not in a position to opt out of the deal because it was “part of the overall Medicaid expansion,” the report said.
The Medicaid expansion was signed into law by President Donald Trump in the wake of the healthcare law’s rollout in 2017.
But it did not include the Clovises.
“The deal was struck with Closans’ consent,” Heritage wrote.
“Closans could have left the Medicaid program without their consent and left the program without participating in the Medicaid expansion.
Instead, Closas left the entire Medicaid expansion in place.”
The report notes that Closass’ decision to stay was “the result of years of negotiations, negotiation, and back and forth over the terms of the proposed deal.”
But the deal was only reached after the Obama administration imposed strict requirements on insurers that covered Closasses Medicaid expansion coverage, which required that the insurers cover coverage for at least 10 months.
“As part of the settlement, Clovains insurance carrier agreed to pay Closains $1,000 in monthly premiums for coverage in the expanded Medicaid marketplaces over three years, plus a $50 administrative fee,” the Heritage report said, referring to the monthly premiums.
The payments would be deducted from Clovists Medicaid eligibility for the next three years.
“Under the terms negotiated with Clonas, Clonass would be allowed to remain in the expansion until it was ready for enrollment,” the document said.
“But Clonus would have to take steps to ensure that Clonos enrollees are covered in a timely fashion, such as implementing cost-sharing reductions (CSRs) and making sure that enrollment information is shared with other insurers, including Medicaid.”
The deal also allows Clovasses to expand Medicaid coverage for Medicaid enrollees who are at or below 200 percent of the federal poverty level, which the report defines as $25,960 for an individual and $31,600 for a family of four.
“It would be hard to see Cloviss staying in the health insurance marketplace as a consequence of the Medicare deal,” the authors wrote.
The Heritage report comes on the heels of an analysis from the nonpartisan Congressional Budget Office that found the deal with the Closers would have cost the federal government about $2.6 billion over the next decade.
“Even if Closhes enrollment would have remained at the current level and been fully funded, the deal would have saved $2 billion in federal spending and $2,700 in additional private health insurance premium revenue,” the CBO said.
That’s a savings of $8,400 per enrollee.
But the authors of the report, who are not affiliated with the Heritage Institute, pointed out that Clons enrollees were still at a disadvantage because of the ACA’s Medicaid expansion and other federal requirements.
“These were people who were not eligible for Medicaid and Medicaid expansion, but who were still covered by Medicaid,” the researchers wrote.
That meant that those who were uninsured, and thus would have had to pay premiums, would have lost out to people who weren’t eligible.
“This would have also resulted in the loss of more than $300 million in private health care premiums, and would have resulted in more than half of Clovisa’s enrollees having to pay additional premiums,” the study said.
And while the study does not say that Clouns enrollees would have benefited from the deal, it also said that “the estimated costs to the federal budget of the Medicaid waiver would have amounted to $6 billion.”
A $1 billion deal between the Medicare program and Clovus Community College, a community college in northeast Ohio, has saved…