PBIRx®
Intelligent Solutions in Pharmacy Benefits
12 Wheelers Farms Road, Milford, CT 06461
(888) 797-2479
Intelligent Solutions in Pharmacy Benefits
12 Wheelers Farms Road, Milford, CT 06461
(888) 797-2479
The following health care actions have been announced by the Trump administration on October 13th. Feedback is starting to come in from Congress, managed care plans, etc. As such, this summary lends itself to change as Trump deals with this feedback.
- Contraception Mandate (amendment to existing August 2012)
- Birth Control Pills, Shots, morning after pill and other devices;
- Broadens entities that may claim religious objections to providing contraceptive coverage, including higher institutions’ student coverage and individuals whose employers are willing to provide health plans consistent with their beliefs;
- Includes moral objections excluding publicly traded companies; and
- License for discrimination; many contesting new mandate
- Allow Employers to form Association Health Plans (AHPs) to:
- Facilitate the purchase of insurance across state lines;
- Allow small businesses in the same line of work or the same trade organization to band together and purchase insurance;
- Provides exemption from ACA regulations including essential benefits
- Critics state that AHPs will draw away healthy patients from the individual market and drive up premiums, though the fact that the plans are limited to small businesses and not individuals could change effect.
- Expand availability of short term, limited-duration insurance from current 3 months to 12 months.
- Discontinue payment of cost sharing subsidies to insurance companies, which offset costs for low-income Americans to be effective immediately.
- Payers will either exit exchanges or increase premiums
- Current and projected taxpayer costs for subsidies are:
- 2017 $7B
- 2018 $9B to $10B
- 2023 $100B
- Expand availability and permitted use of Health Reimbursement Arrangements (“HRAs”) to include premium costs
- HHS, Labor Dept and Treasury Department “proposed rule changes” due:
- 60 days AHPs and Short Term Plan expansion
- 120 days HRA changes
Blue Cross Blue Shield of Massachusetts has weighed in and released the following statement:
"We are deeply concerned that the Administration's recent actions will create further instability in the insurance market and threaten our shared goal of providing affordable and quality coverage and care to everyone, regardless of economic status, age, or condition.
At Blue Cross and Blue Shield of Massachusetts, our highest priority is ensuring that quality health coverage is accessible and affordable for our members, employer customers, and the community. The measures proposed by the Administration would likely create an unfair and unstable market, making coverage out of reach for those who need it most and undermining the meaningful progress that our state and nation have made in extending health insurance coverage to our fellow citizens.
We encourage policy makers to work in a bipartisan spirit to improve the Affordable Care Act to create a health care system that is high quality, affordable, and sustainable."
PBIRx will closely monitor any updates to these Executive Orders by the Trump Administration and will keep you abreast of any changes.
PBIRx has been exclusively providing intelligent solutions to clients in the management of pharmacy benefit costs since 1993. With a staff that includes IT personnel, actuaries, financial analysts, clinical pharmacists, attorneys, HIPAA Compliance Officers and many more experts, PBIRx’s mission is to create optimal health care outcomes while minimizing overall health care costs. For more information, please visit www.pbirx.com or call (888) 797-2479.
