Premium Reduction Act of 2019

Premium Reduction Act of 2019

This bill provides funding for grants for states to establish invisible high-risk pool and reinsurance programs through applications for state innovation waivers from certain health insurance coverage requirements. A reinsurance program generally permits health insurance issuers to transfer a portion of the cost of the coverage for enrollees with large claims to the state, thus facilitating the enrollment of higher-risk individuals, including those with preexisting conditions. Similarly, an invisible high-risk pool generally identifies and enrolls higher-risk individuals and the state program pays a percentage of any insurance claims of such enrollees that exceed a predetermined amount.

In states that do not establish such programs, the Department of Health and Human Services (HHS) must make market stabilization payments to health insurance issuers.

The bill further directs HHS to expedite the review of state innovation waiver applications that include a high-risk pool or reinsurance program. States may model a waiver application on the application of a state that has an approved waiver for such a program.