The U.S. Office of Personnel Management (OPM) is proposing regulations for a new “Multi-State Plan Program” (MSPP) that could, in effect, give ordinary consumers access to health plans that are similar to the plans federal employees use.
OPM has posted a 122-page preliminary version of the MSPP regulations on the Web.
The regulations are set to appear in the Federal Register Dec. 5.
Comments will be due 30 days after the official Federal Register publication date.
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Drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) included the MSPP provision in PPACA in an effort to give Americans access to the kind of health coverage that members of Congress get.
PPACA requires state or federal regulators to provide health insurance exchange programs — Web-based health insurance supermarkets — throughout all U.S. states and the District of Columbia. Individuals and small groups are supposed to be able to use new tax subsidies to buy high-quality “qualified health plan” (QHP) coverage through the exchanges.
Each exchange user is supposed to have access to two “multi-state plans” (MSPs) — plans administered by OPM that have the ability to operate across state lines.
OPM runs the popular Federal Employees’ Health Benefits Program, a plan that offers members of Congress, congressional staffers, and most other federal employees access to a menu of health benefits options from many different carriers.
In a preamble to the proposed regulations, officials said of MSP vendors that:
- An MSP can phase in the states in which it offers coverage over four years, but it must offer MSPs through all operating PPACA exchanges within four years after joining the MSP program.
- The term of an MSP contract would be at least 12 months.
- Vendors might have to pay user fees, to help OPM cover the cost of running the MSP program.
- OPM is still thinking about whether and how to require MSPs to offer coverage in all areas of all states in which they operate.
- OPM would work with states to regulate MSP rates, but the final authority over MSP rates would rest with OPM.
- OPM intends for MSPs to be subject to any federal or state regulations concerning how risk pools will be combined or split.
- An MSP would have to participate in the new PPACA programs that are supposed to help manage PPACA-related antiselection risk.
OPM recently posted information about a job opening for an MSPP program analyst who would help support the process of contracting with MSPP contractors.
One question has been how federal regulators will reconcile the desire to make multi-state plans available with many health policy specialists’ concerns about the possibility of MSPs evading state benefits mandates or other state health insurance laws, such as laws governing complaint processes.