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April 03, 2018 12:00 AM

Ohio seeks first-ever individual mandate waiver

Virgil Dickson
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    Ohio officials asked the Trump Administration on Friday to formally waive the Affordable Care Act individual mandate that requires residents to have health insurance, making it the first state to make such a waiver request.

    Ohio's Legislature called for the 1332 waiver last summer, and Congress zeroed out the financial penalty for not having coverage in its tax bill in December.

    "The (tax) legislation zeroed out the penalty that is associated with the individual mandate … but … did not eliminate the mandate itself," Ohio Department of Insurance Director Jillian Froment said in a March 30 letter to HHS Secretary Alex Azar. "That is why Ohio is submitting an application to waive [the mandate]."

    If approved, the request could make insurance more affordable for many Ohio residents or open the state up to legal risk, according to experts.

    Ohio consumers may not be aware that the federal tax bill eliminated the mandate's financial penalty, according to Tara Straw, a senior policy analyst at the Center on Budget and Policy Priorities. But she said some healthy people may leave the individual market due to the waiver request, leaving only the sickest consumers with coverage and forcing insurers to raise premiums.

    In its application to HHS, Ohio actuaries predicted individual market enrollment will fall from 307,000 people this year to 248,000 enrollees in 2022, and average monthly premiums will increase from $493 to $600 in the same time frame.

    State officials and Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation, attribute the projected enrollment drop in Ohio's application to the elimination of the tax penalty versus the waiver request itself.

    Tolbert overall questioned the need for the waiver, given the recent federal tax legislation, but said it's still worth keeping an eye on HHS' decision since the agency declined to approve some 1332 waivers late last year.

    "If this one was also denied, it would certainly send a signal to states that the administration isn't interested in the use of 1332 waivers by states to make a change to the insurance market," Tolbert said.

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