CMS releases proposed rule to stabilize Health Insurance Marketplaces

The Centers for Medicare & Medicaid Services today issued a proposed rule designed to help stabilize the Health Insurance Marketplaces. The rule proposes changes in six areas: special enrollment periods; guaranteed issue; actuarial value; network adequacy; qualified health plan certification calendar; and open enrollment periods. The new policies are intended to make certain coverage options more affordable to consumers, reduce certain administrative burdens on plans, and reduce adverse selection to improve the risk pools. Most of the policies would go into effect for the 2018 plan year, but several would be implemented in 2017. The changes would not apply to states that operate their own Marketplaces. “The AHA has long advocated for measures to stabilize the insurance marketplaces, and we appreciate that the Administration signaled its commitment to working to achieve this goal,” said AHA Executive Vice President Tom Nickels. “We believe many of today’s proposals have the potential to make participation in the marketplaces more appealing to insurers and consumers, such as allowing insurers to offer less-expensive options. However, we will be reviewing them in more detail to ensure that they both improve consumer access to coverage and maintain important consumer protections including maintaining access to essential community providers. We are committed to working with the Administration to protect this vital coverage source for consumers.” For more on the proposed rule, see today’s AHA Special Bulletin for members.