HHS Disapproves Ohio’s Request to Eliminate ACA Individual Mandate in State

The Department of Health and Human Services (HHS) has rejected a waiver request from the Ohio Department of Insurance (ODI) to eliminate the Affordable Care Act (ACA) individual shared responsibility mandate in the state.

As originally written, that provision of the ACA requires all Americans to have health insurance or pay a fine, but as part of the GOP’s Tax Cuts and Jobs Act of 2017, the penalty part of the individual mandate, by which it is widely known, will be eliminated in 2019.

In rejecting the request, the Centers for Medicare and Medicaid Services (CMS), the wing of HHS that administers the ACA, stated  that the “application does not include a description of the reason that the state is seeking to waive IRC $50004(a),” the individual mandate provision. In addition, the rejection letter noted that each state, even when requesting a waiver, must ensure that it  provides a state plan for health insurance that is “at least as comprehensive and affordable as that provided under” the ACA.

Though the Trump administration and Republicans in Congress have tried to void the ACA, falling one vote short in the Senate, CMS has staunchly defended the provisions of the legislation. It recently rejected a request by Kansas to put a cap on enrollment in Medicaid, which was expanded as part of the ACA.

The administration, however, has allowed states to impose a work requirement on the able-bodied — get job training, do community work, or get a job if you want to stay on Medicaid.

Overall, the push has been to give the states more latitude and authority over their programs, said CMS Administrator Seema Verma.

“I hope to get to a new era where states are driving their programs, and they are deciding what is going to work best in their communities, because they are closest to the people they serve,” she said. “And we can hold states accountable for shaping outcomes so we can measure what they are doing.”

ODI was required to seek the waiver through a provision from Republican lawmakers. The department paid an actuarial firm nearly $400,000 to help with the waiver.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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