Patient Protection and Affordable Care Act's (ACA's) Transitional Reinsurance Program [November 16, 2016] [open pdf - 866KB]
"Section 1341 of the Patient Protection and Affordable Care Act (ACA; P.L. [Public Law] 111-148, as amended) establishes a transitional reinsurance program that is designed to provide payment to non-grandfathered, non-group market health plans (also known as 'individual' market health plans) that enroll high-risk enrollees for 2014 through 2016. Under the program, the Secretary of the Department of Health and Human Services (HHS) collects reinsurance contributions from health insurers and from third-party administrators on behalf of group health plans. [...] This report provides an overview of one of the three risk-mitigation programs, the transitional reinsurance program. The program's aim is to offset the expenditures associated with high-cost individuals. The first section of the report provides background information on reinsurance and the ACA risk-mitigation programs. The second section describes the components of the transitional reinsurance program, as well as the amounts currently collected and remitted through the program. The third section discusses questions, including those raised by a recent Government Accountability Office report, regarding the scope of HHS's authority to administer the transitional reinsurance program. The last section briefly summarizes relevant legislation regarding the transitional reinsurance program. Finally, the report includes a table in the Appendix that summarizes key aspects of the transitional reinsurance program."
CRS Report for Congress, R44690
Federation of American Scientists: http://www.fas.org/sgp/crs/index.html