Following Push From Sens. Grassley and Ernst, CMS Protects High-Quality, Affordable Health Insurance for 65,000 Iowans

WASHINGTON, March 26 -- Sen. Charles E. Grassley, R-Iowa, issued the following news release on March 25, 2022:

This week, the Centers for Medicare & Medicaid Services (CMS) protected high-quality, affordable health insurance for 65,000 Iowans by extending transitional health plans for Calendar Year (CY) 2023. CMS took action by extending a non-enforcement bulletin issued under both Democrat and Republican administrations since 2013. This action follows Sens. Chuck Grassley (R-Iowa) and Joni Ernst's (R-Iowa) February letter requesting that CMS quickly permit transitional health plans to be sold in CY 2023.

"Over 65,000 hardworking Iowa farmers, small business owners and their families currently access high-quality and affordable health insurance through transitional health plans," Grassley said following CMS's action. "I appreciate CMS extending these health plans to be sold in CY 2023. This action will provide Iowans predictability and stability in their health care."

"Tens of thousands of Iowans signed onto a health care plan they were told they could depend on, and it's important this administration honors that promise, as Democratic and Republican administrations have in the past," Ernst said. "I'm pleased CMS made the call to extend these health plans so Iowa families can continue to get quality care uninterrupted."

"The leadership of Senators Grassley and Ernst has been critical to ensuring that rural Iowans have access to quality and adorable healthcare. Affordable healthcare is vital to the health of our rural communities and the Iowa Farm Bureau appreciates their leadership," said Iowa Farm Bureau.

"Since 2013, federal authorities have provided state flexibility permitting transitional policies to continue. Transitional plans provide access to healthcare coverage that is likely otherwise unaffordable. Year after year, Iowans have the opportunity to enroll in Affordable Care Act (ACA) plans but many choose to stay in transitional plans to avoid the very high ACA rates, especially those in the individual market. This federal action will provide predictability and stability for Iowans," Iowa Insurance Commissioner Doug Ommen said.

In their February letter, Grassley and Ernst wrote, "To maintain the promise of 'if you like the plan you have, you can keep it,' the Obama administration issued guidance allowing state insurance regulators to permit transitional health plans to be sold to existing customers. The Trump administration continued this policy. Transitional health plans are required to protect from discrimination of an individual's health status and pre-existing conditions."

Transitional health plans refer to insurance coverage that was purchased after Obamacare became law in 2010, but before it was formally implemented in 2013. These high-quality plans, which cover more than one million Americans, offer additional choice in the health insurance marketplace, and they protect patients with pre-existing conditions. The administration must extend these plans each year so they do not expire. Both the Obama and Trump administrations routinely extended transitional health plans, but CMS has not committed to maintaining this bipartisan policy for 2023 or further into the future.

Grassley has previously advocated for access to transitional health plans, including in a 2017 letter (https://www.wicker.senate.gov/services/files/7FBDF1D0-4651-4CBF-B381-56F65771FD0A) to Health and Human Services (HHS) Secretary Tom Price, during a Finance Committee hearing with HHS Secretary Alex Azar and in questions for-the-record for CMS Administrator Brooks-LaSure.

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February 21, 2022

To: The Honorable Chiquita Brooks-LaSure, Administrator, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services, 200 Independence Avenue S.W., Washington, D.C. 20201

Dear Administrator Brooks-LaSure,

Over 65,000 hard-working Iowa farmers, small business owners, and their families currently access high-quality and affordable health insurance through transitional health plans. /1 The Centers for Medicare & Medicaid Services (CMS) has permitted these plans for approximately a decade. /2 We request that CMS quickly permit transitional health plans to be sold in Calendar Year (CY) 2023 to provide Iowans predictability and stability in their health care.

Both the Obama and the Trump administrations agreed in eight previous "Extension of Transitional Policy" bulletins that more than one million Americans should be able to access health insurance they began purchasing between March 23, 2010, and October 1, 2013. /3 To maintain the promise of "if you like the plan you have, you can keep it,"/4 the Obama administration issued guidance allowing state insurance regulators to permit transitional health plans to be sold to existing customers. The Trump administration continued this policy. Transitional health plans are required to protect from discrimination of an individual's health status and pre-existing conditions. /5 At the state level, the Iowa Insurance Commissioner has permitted transitional health plans to continue./6 CMS has not committed to maintaining this bipartisan policy for CY 2023 or further into the future.

For example, some Iowa farmers and entrepreneurs purchase transitional health plans as members of the Iowa Farm Bureau./7 These transitional health plans have experienced low annual premium increases and offer consumer choice in lower deductibles at $1,000 and $1,500, out-of-pocket caps, and a nationwide network of providers through a preferred provider organization (PPO)./8 They have also provided critical benefits such as preventative care services with no cost sharing, no annual or lifetime caps on benefits, and protection from discrimination of an individual's health status and pre-existing conditions. /9 If Iowans with a transitional health plan purchase a health plan on the federal Health Insurance Marketplace, a majority (83%) of them will face premium increases./10 Of these individuals, 41% will see their premiums increase more than 50%./11 They will also lose access to a PPO provider network. /12 This will mean a narrower network of providers. Also, a comparable federal Health Insurance Marketplace silver plan will have a $5,155 deductible in CY 2022, which is three-to-five times what Iowans with a transitional health plan have today. /13 If transitional health plans are discontinued past CY 2022, over 65,000 Iowans with high-quality and affordable health insurance will go without health insurance or face increased health care costs, diminished access to health care providers, and less consumer choice.

We support Iowans having access to a choice of high-quality and affordable health insurance that protects from discrimination of an individual's health status and pre-existing conditions. We urge you to take action quickly to maintain transitional health plans in CY 2023, so Iowans can have peace-of-mind.

Sincerely,

Charles E. Grassley, United States Senator

Joni K. Ernst, United States Senator

View footnotes here: https://www.grassley.senate.gov/imo/media/doc/grassley_ernst_to_cms_-_transitional_health_plans.pdf