- HHS Secretary Kathleen Sebelius announced in a letter Wednesday that qualified health plan issuers may accept premium and cost-sharing payments from third parties.
- Patients must receive the funds through private, not-for-profit foundations; furthermore, patients may be selected only for their "financial status," not for their health status.
- The letter further dictates that CMS "would expect that premium and any cost sharing payments cover the entire policy year."
Up until now, the administration had provided no clear guidance on whether private foundations were permitted to subsidize exchange plan premiums. In November 2013, HHS said that it "discouraged" the practice because it might "skew the insurance risk pool." A Q&A released in February claimed that the organization was not discouraging the practice; in March, an Interim Rule announced that marketplace plans were required to accept premium subsidies on behalf of enrollees in some federal and state government programs, but provided no regulations beyond that.
The American Hospital Association and the Catholic Health Association sent a letter imploring the administration for guidance at the end of April, and HHS now appears to be responding to industry pressure to provide clarification.