Close Close

Life Health > Health Insurance

CMS lets 'grandmothered' plans live another year

Your article was successfully shared with the contacts you provided.

The federal agency in charge of Affordable Care Act programs is continuing to prepare for the possibility that the U.S. health insurance markets could look about the same in 2018.

Related: CMS posts 2017 PPACA World rules

The agency, the Center for Consumer Information and Insurance Oversight, today renewed a policy that lets insurers keep “grandmothered” individual and small-group major medical plans alive.

CCIIO, an arm of the Centers for Medicare & Medicaid Services, has put out similar grandmothered plan survival notices every year since 2014.

While President Barack Obama was stumping for the legislation that created the ACA, he often told crowds that, “If you like your coverage, you can keep it.”

Obama signed the two bills that created the ACA into law in March 2010. The ACA itself contains a provision that lets customers hang on to “grandfathered policies,” or major medical insurance policies written before March 23, 2010, when the older bill in the package, the Patient Protection and Affordable Care Act bill, was signed.

In 2013, as major ACA rules and programs were taking shape, many people said that they thought “if you like your coverage, you can keep it” applied to all coverage in effect before Jan. 1, 2014, when most of the new ACA commercial health insurance rules and programs officially came to life.

The Obama administration’s CCIIO handled the controversy by creating “grandmothered plans.” Grandmothered plans are individual or small-group major medical plans that were originally sold after March 23, 2010, but before Jan. 1, 2014. The issuers of the grandmothered coverage can avoid complying with many of the ACA rules that apply to individual and small-group policies sold on or after Jan. 1, 2014. In some cases, the grandmothered plans might be cheaper than fully ACA-compliant plans, and they might offer lower deductibles or other attractive features.

CCIIO issued the first grandmothered plan survival notice, for the 2015 plan year, in March 2014. The notices let insurers keep grandmothered coverage in force in a state, if the state’s regulators, and the insurers operating in the state, want to do that. States and insurers can choose whether or not to continue to offer grandmothered coverage.

Under the new CCIIO notice, in states that let grandmothered coverage stay in force, an insurer can renew grandmothered coverage up until Oct. 1, 2018. The grandmothered coverage can stay in effect until Dec. 31, 2018.

The notice for 2018 identifies Jeff Wu as acting CCIIO’s acting director.

The previous notice, for 2017, identified Kevin Counihan was CCIIO’s director.

Wu has a bachelor’s degree in economics from Harvard, and a law degree and master’s degree in business from Stanford University.

He spent two years working as a consultant at Oliver, Wyman & Company in New York, and he has been working on ACA-related programs at CCIIO since October 2011, according to his LinkedIn entry. Before he took over as the acting head of CCIIO, he was the associate deputy director for policy.

President Donald Trump and many Republicans in Congress say they hope to repeal and replace the ACA. In the new notice, CCIIO assumes as a given that the current rules will stay in effect in 2018.


West Virginia loses ‘unusual’ health law challenge in D.C. Circuit

CCIIO posts grandmothering relief numbers

We’re on Facebook, are you?