The Department of Health and Human Services issued it final rule for 2018 market stabilization for the Affordable Care Act’s federal and state exchange insurance markets. Stabilizing individual markets is the key to the sustainability of the ACA. The rule includes several changes that had been under consideration by the former administration including: 1. a shorter open enrollment period, 2. greater restrictions on signing up during special enrollment periods, 3. allowing states to determine their own network adequacy standards, 4. defering to state regulators decisions on licensure and the good standing of qualified health plans (QHPs), and 5. reducing the percentage of required essential community providers that an insurer must have in their network.
Two key components were not addressed in the rule: 1. the continued funding and administering of the cost-sharing reduction payments to insurers, and 2. the enforcement of the individual responsibility requirement. For a fuller understand of the final rule, please access the following links.
Read the news release from CMS.gov
Read more at Health Affairs Blog.