Hartford, Conn.-based Aetna submitted feedback in response to the proposed changes CMS issued last month to stabilize the health insurance market, according to the Hartford Courant.
Here are six takeaways from the insurer's response.
1. Aetna's Executive Vice President of Corporate Affairs Steven Kelmar wrote the insurer's response to the proposed changes, filed with HHS March 6. He said Aetna "believe[s] [the proposed rules are] a good first step in making improvements. However, given the current state of the individual health insurance market, more is needed if consumers are to have access to affordable coverage in 2018 and beyond."
2. Aetna listed cutting the federal marketplace's annual open enrollment period in half and increased verification of special enrollment eligibility among the proposals the insurer supported. The payer said it also supported requiring policyholders to pay past-due premiums before enrolling in new coverage.
3. Mr. Kelmar said Aetna would like to see more flexibility for plan design involving bronze, silver and gold options. The insurer would also like to see provisions allowing states to take over review of health plans and insurance networks.
4. Mr. Kelmar added the insurer wants CMS to establish a surcharge for individuals who have a lapse in coverage. Aetna said the penalty should be between 1.5 times or double the normal premium for individuals who enroll in a new plan more than 63 days after lapsed coverage.
5. Aetna also would like to see a 5 to 1 ratio in terms of how much more insurers can charge older policyholders compared to their younger counterparts. Under the ACA, payers can only charge its oldest customers premiums that are three times higher than premiums charged to young adults, according to the Hartford Courant.
6. Since 1 percent of Aetna's customers represent 44 percent of the payer's claims cost, Aetna said a risk adjustment mechanism like reinsurance needs to be in place to balance risk pools and keep coverage costs down. The ACA had a temporary reinsurance program that ended in 2016. Aetna said if a similar risk adjustment program is not instated, consumers will continue to see more than 20 percent increases in premium costs and fewer choices, according to Mr. Kelmar's response.
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