CMS releases final ACA market stabilization rule: 5 things to know
CMS issued a final rule Thursday aimed at stabilizing the ACA's individual health insurance market.
Here are five things to know about the final rule.
1. The annual open enrollment period is shortened from three months to six weeks under the final rule. The 2018 enrollment period will begin Nov. 1 and run through Dec. 15. This change will help encourage individuals to enroll in coverage prior to the beginning of the year, according to CMS. Timothy Jost, a law professor at Washington and Lee University and a health law expert, told The Wall Street Journal shortening the open enrollment period may result in fewer younger consumers enrolling in coverage because they historically sign up for coverage toward the end of the enrollment period.
2. The final rule includes stricter requirements for special enrollment periods. Individuals will have to provide supporting documentation for special enrollment periods outside of the annual sign-up period. "It will encourage individuals to stay enrolled in coverage all year, reducing gaps in coverage and resulting in fewer individual mandate penalties and help to lower premiums," said CMS.
3. Individuals will be required to pay overdue premium payments before enrolling in new coverage with the same insurer. CMS said this change is aimed at encouraging individuals to maintain continuous health insurance coverage throughout the year.
4. The final rule gives insurers more flexibility in deciding how much of consumers' costs to cover. This move could result in insurers offering plans with lower premiums but higher deductibles.
5. The federal government will end its review of health plan network adequacy under the final rule. This oversight will be left to the states, as they are best positioned to review network adequacy, according to CMS.
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