The Trump administration is giving insurers a few more weeks to decide whether to sell individual or small-group major medical coverage in 2018.
The Centers for Medicare & Medicaid Services has published two notices that push back key filing dates for insurers that want to sell 2018 coverage.
CMS is part of the U.S. Department of Health and Human Services. HHS set up HealthCare.gov, an Affordable Care Act public exchange enrollment system, to handle ACA exchange enrollment in states that decided against handling that job themselves.
Some of the new deadline changes apply only to HealthCare.gov plans. Other deadline changes apply to all individual and small-group health plans.
President Donald Trump and Republicans in Congress have proposed repealing and replacing the ACA. The federal government could restructure health care laws and regulations in a way that would eliminate the need for filing deadlines, or require regulators to change the filing deadlines a second time. At this point, however, ACA statutes and regulations still govern how the U.S. health insurance market will work in 2018.
HealthCare.gov filing changes
Insurers that want to sell plans through HealthCare.gov can now file applications for 2018 HealthCare.gov slots from May 10 through June 21, according to a filing schedule notice. Originally, the HealthCare.gov filing window was going to run from April 5 through May 3.
CMS has pushed the rate table filing deadline for HealthCare.gov plans back to June 21, from May 3.
For 2018, the open enrollment end date could be Dec. 15. (Image: iStock)
Rate review filing changes
CMS also oversees a separate rate review program for all individual and small-group plans, and the agency actually runs the rate review for some states.
For issuers in states in which CMS runs the rate review program, the initial rate filing deadline will move to June 1, from May 3.
For issuers in states in which CMS simply oversees the state’s rate review program, the initial rate filing deadline will move to July 17, from June 1, unless the state sets an earlier deadline.
Originally, CMS hoped to post proposed rates for 2018 plans on a public website by June 30. CMS now expects proposed rates to go up on the web Aug. 1.
Open enrollment for 2018 is now set to start Nov. 1. CMS does not expect to have final 2018 rates available until Nov. 1.
Open enrollment period
Regulators, insurers and ACA exchange managers developed the open enrollment system, or limits on when people can buy individual coverage without going through extra red tape, to try to scare healthy people into paying for coverage.
The ACA now requires insurers to sell major medical coverage without thinking about the applicants’ health problems, but the law lets insurers limit when they sell health coverage.
The open enrollment period system is supposed to confront healthy people with the possibility that, if they fail to pay for coverage during the open enrollment period, they may get sick and run up big bills at a time when they cannot buy coverage.
Otherwise, supporters of the system say, healthy people might see the ACA ban on medical underwriting as an invitation to wait until they get sick to pay for coverage.
For the past two years, the open enrollment period for a year ran from Nov. 1 through Jan. 31.
This year, CMS has proposed in draft regulations to have the open enrollment period for 2018 run from Nov. 1, 2017 through Dec. 15, 2017. The new filing deadline revision notice shows the open enrollment period for 2018 running from Nov. 1, 2017, through Jan. 31, 2018.
Correction: An earlier version of this article described the originally proposed 2018 open enrollment period end date incorrectly. Regulators proposed that the 2018 open enrollment period should end on Jan. 31, 2018.
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