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.
