OPINION: Reimbursement pools in these 7 states significantly reduced Obamacare premiums. The rest of the country should take note.
In 2019, seven U.S. states tried an innovative experiment to improve the Affordable Care Act by operating reimbursement pools, which pay back ACA insurers a specified portion of their expensive health-care claims.
The seven states were Alaska, Maine, Maryland, Minnesota, New Jersey, Oregon and Wisconsin. They were motivated to try reimbursement pools because they had few insurers offering policies on their ACA exchanges and/or the premiums on individual policies were rapidly rising.
The cost of Minnesota’s reimbursement pool was financed partly by a “pass-through” payment of $84.7 million from the federal government to the state in 2019. This payment represented the reduction in federal subsidies, required by the ACA to be provided to low and moderate-income families buying health-care policies on the ACA exchange in Minnesota.
The calculation of the benefits of a state’s reimbursement pool to subsidized policy holders on its ACA exchange is more complex. Under the ACA, low- and moderate-income families pay only a prescribed percentage of their income for policies bought on ACA exchanges. This percentage is calculated on the assumption that these families will buy a middle-level silver policy, rather than a gold policy with more health-care benefits or a bronze policy with fewer benefits.
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