The exchanges begin enrolling individuals and small businesses Oct. 1, where they can buy health plans that begin on or after Jan. 1. The exchanges are intended to boost insurer competition and improve customers’ buying power through more transparent comparisons between plans, and the exchanges will also screen applicants for eligibility for Medicaid or subsidies to help pay for insurance.
Taking efforts to promote affordability even further, Ms. Sebelius said the agency will negotiate with payers by alerting them if their rates are “outliers” relative to others offered on the exchanges, allowing insurers to reconsider their pricing or correct the rates if HHS or the payer made an error. This can promote competitive pricing, but the strategy’s effectiveness is challenged in markets with low payer participation in the exchanges, according to the report.
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