The Department of Health and Human Services (HHS) will make changes favorable to insurers in an effort to keep them from leaving the ObamaCare exchanges or raising premium costs next year.
If the law collapses under the Trump administration, Republicans could take the blame. A GOP replacement bill was pulled from the House floor last month after it became clear it didn’t have the votes to pass.
The new rule includes several changes insurers have requested:
- Reducing the duration of the sign-up period for 2018 by half, lasting from Nov. 1 to Dec. 15.
- Requiring people who sign up for coverage in special enrollment periods to prove they qualify — for example, if they moved and needed new a new plan. This change is intended to cut down on people only signing up for coverage once they get sick.
- Allowing insurers to require people pay past-due premiums before enrolling in a new plan with the same insurer the following year.
- Allowing insurers the flexibility to offer health plans with fewer options. Democrats warn that because of the structure of ObamaCare’s subsidies, this change could actually lead to a reduction in subsidies for some people.
Insurers called the rule a good first step when it was proposed in February, but they are still waiting for information about how the administration will handle ObamaCare’s insurer reimbursements.
Insurers have threatened to raise premiums or leave the ObamaCare exchanges if they don’t get payments that reimburse them for offering discounted deductibles to low-income people.
The Trump administration has said it will continue those cost-sharing reductions while a House GOP lawsuit over the legality of those payments plays out.
Insurers would rather see those payments specifically appropriated by Congress.
Marilyn Tavenner, the president and CEO of America’s Health Insurance Plans (AHIP) and the former Centers for Medicare and Medicaid Services administrator, praised the rule for adopting “important changes” to “improve the functioning of the individual market” but said insurers still need to hear about the cost-sharing reduction subsidies.
“There is still too much instability and uncertainty in this market,” she said.
“Most urgently, health plans and the consumers they serve need to now that funding for cost-sharing reduction subsidies will continue uninterrupted. Without funding, millions of Americans who buy their own plan will be harmed.”
She warned that many plans would likely drop out of the market if the payments aren’t continued and premiums could go up as much as 20 percent.
“We urge Congress and the administration to act now to guarantee funding for cost-sharing reduction subsidies,” she said.