17 Feb Tracking Healthcare Changes under the New Administration

The passage of the Patient Protection and Affordable Care Act (ACA) in 2010 was significant legislation that resulted in a variety of changes in the healthcare industry.  There is now a great deal of talk in Washington about repealing, replacing, revising, (or some combination of the three) the ACA.  We don’t yet know how the law may change and what effect this may have on the healthcare industry.  We will share information on healthcare changes with our readers as it becomes available.

Wednesday this week, HHS submitted a proposed rule published today in the Federal Register, intended to stabilize the existing health exchange insurance markets.

There are four ways HHS has proposed to help stabilize these markets:

 

1. Reducing the open enrollment period for the 2018 benefit period to 11.1.2017 – 12.15.2017. Open enrollment has typically lasted into January.  The goal of this measure is to improve the risk pool by encouraging earlier enrollment for the healthier population, and to deter late enrollment by those delaying enrollment who learn late in the year that they have a health need for coverage.

2. Changes to special enrollment periods to deter those only enrolling once they determine that they have a need for services. The goal is to even out the risk pools and promote continuous coverage, as opposed to healthy individuals avoiding coverage until their risk increases due to a developed need for health care services.

3. A revision to the interpretation of the guaranteed availability requirement which, to date, has resulted in the delay, by some enrollees, in the payment of their premiums. The goal is to encourage continuous coverage, thereby balancing the risk pools.

4. A proposal to change the determination of metal levels of coverage for the 2018 benefit year. The goal of this change is to allow insurance companies greater flexibility in designing new plans, intended to keep cost sharing more constant year to year.

 

The public comment period on this proposed rule is open until March 7, 2017.

For more information, please see the published proposed rule in the Federal Register:

https://www.federalregister.gov/documents/2017/02/17/2017-03027/patient-protection-and-affordable-care-act-market-stabilization

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