Uncertainty Surrounding the Affordable Care Act

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Around 12.2 million people signed up for health insurance coverage through federal and state-run Exchanges during the 2017 open enrollment period, which ended on January 31. This is 4% less sign ups than we saw last open enrollment period. Some say the reduction is attributed to sky high premiums and deductibles in the individual market. Others argue the reduction is due to the Trump administration scaling back on open enrollment advertising.

Both factors probably played some role in the reduction, along with the uncertainty surrounding the future of the Affordable Care Act (ACA), also known as Obamacare.

Carriers like Aetna, Anthem and Cigna have expressed their own concerns. What lies ahead could cause them to exit certain markets and/or price their plans differently. That would mean less choice and another round of significant premium hikes unless adequate action is taken, and the clock is ticking since rate filings for plans to be sold in 2018 are due in May.     

Fortunately, the uncertainty of repeal, replace, repair, remodel, retool, refine or whatever actually takes place is leading to some regulatory action for the individual market.  The Trump administration, through the Centers for Medicare and Medicaid Services (CMS), recently filed a regulatory notice in an effort to stabilize Exchanges and keep carriers in the market of selling individual health insurance plans in 2018 and future years. 

The actual text of the notice has not been released to the public so it’s not clear (yet) what changes may come, however, based on previous comments there is a belief that the notice could tighten up requirements for special enrollment periods and shorten the grace period for late premium payments, among other things. These are changes desired by carriers who claim the special enrollment and grace period rules are being abused.

The regulatory notice will be released after its been reviewed by the Office of Budget and Management (OBM), and it will be made available for public comment for a period of at least 30 days. The release is expected in the near future, and it will likely trigger a lot of media commentary.