- HHS created a new online resource that highlights the regulatory and administrative actions the federal department has taken for an Affordable Care Act (ACA) repeal.
HHS believes that these actions are necessary to relieve burdens of the current healthcare laws under the ACA and deliver a patient-centric healthcare system.
“We’re taking action to improve choices for patients, stabilize the individual and small-group insurance markets, and expand access to more affordable coverage,” said HHS Secretary Tom Price, MD. “This page will be the place to go for updates on our ongoing efforts.”
Price has spoken on behalf of the HHS stating his approval for the American Health Care Act (AHCA), a bill that aims to repeal the ACA. He also decried the recent Congressional Budget Office’s report that 14 million Americans would lose health insurance by 2018 under the AHCA.
The webpage, found here, outlines three actions that HHS has taken to determine which ACA components benefit patients. The actions include helping patients to retain their health plans, streamlining payer deadlines for offering plans, and proposing new ways to stabilize health insurance exchanges.
The first section redirects viewers to an outline on how HHS plans to allow consumers to keep their pre-ACA plans.
Known as transitional coverage, CMS extended the length of this qualified pre-ACA coverage into 2018. HHS states that by allowing patients to keep their transitional coverage, they will be able to freely keep the insurance they like without having to pay individual mandates.
The decision is also an HHS effort to lower premiums for entrepreneurs, retirees, and small business employees.
The webpage’s second section details the extended deadlines for payers to meet the Qualified Health Plan (QHP) certification for federally-facilitated marketplaces. The calendar includes extended dates for key reviews such as single risk-pool coverage along with risk-adjustments and re-assurance.
“With the uncertainty in the insurance market right now, insurers need all the time they can get to gather data, crunch the numbers, and figure out what kinds of plans they can offer next year,” HHS said. “The more time insurers have, the better choices they’ll be able to offer consumers.”
Included on the new webpage are a number of proposals released on stabilizing the health insurance market.
HHS believes that one of the ways of doing this is by allowing payers more flexibility to restructure financial models for plans, leading to lower premiums.
“Currently, insurers have to sell plans that adhere to rigid rules about how much is covered: ‘ bronze’ plans must cover between 58 to 62 percent of the costs a patient has in a given year, ‘silver’ plans 68-72%, and so on,” HHS said.
“The new rule would widen the bands within which insurers can offer plans—including plans with lower premiums than have previously been possible under the ACA—so more Americans would be able to find plans that work for their budget,” the federal department added.
HHS also proposed to lift and streamline one-size-fits-all requirements for payers.
“Many Americans want to purchase coverage that provides access to a wide range of hospitals and doctors,” HHS said. “But that does not make sense for everyone: Plenty of others want to save on their premiums by purchasing plans that only contract with a certain set of health providers.
HHS says that this will lower regulatory costs that are passed on to individuals and families, and provider broader options for americans who want coverage.
Another major issue HHS plans to address is consumers who “game the system,” or take advantage of insurance policies by only using coverage when they are sick, and then immediately dropping it.
HHS proposals that combat “gaming the system” include a new open enrollment period similar to the ACA one and requiring documentation to change coverage based on a qualifying life event,like marriage or job loss.
The HHS also proposes that payers are allowed to collect past unpaid premiums from customers who bought coverage, chose not to make payments on it, and then purchased a different plan from the same insurer.
“The Affordable Care Act, along with other existing laws, helps protect sick people from being denied insurance coverage,” HHS said. “We strongly believe in that promise, but it can encourage people to buy into the market when they are sick and then drop the coverage once they are healthy.”
“This gaming of the system is pretty common. It raises insurance premiums and reduces choices for people who are trying to do the right thing.”
HHS stated that it intends to set these actions in motion as soon as they are allowable by federal law, such as the pending ACA repeal and replace.