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Valued Social Butterfly
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Re: CMS Issues Final Rule To Increase Choices and Encourage Stability In Health Insurance Marketplac

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@GailL1 wrote:

These don't fix it but may help.  What do you think?

CMS Press Release on Final Rule to Increase Choices and Encourage Stability in Health care Marketpla...

 

The final rule makes several policy changes to improve the market and promote stability, including:

 

2018 Annual Open Enrollment Period: The final rule adjusts the annual open enrollment period for 2018 to more closely align with Medicare and the private market. The next open enrollment period will start on November 1, 2017, and run through December 15, 2017, encouraging individuals to enroll in coverage prior to the beginning of the year.

 

Reduce Fraud, Waste, and Abuse: The final rule promotes program integrity by requiring individuals to submit supporting documentation for special enrollment periods and ensures that only those who are eligible are able to enroll. It will encourage individuals to stay enrolled in coverage all year, reducing gaps in coverage and resulting in fewer individual mandate penalties and help to lower premiums.

 

Promote Continuous Coverage: The final rule promotes personal responsibility by allowing issuers to require individuals to pay back past due premiums before enrolling into a plan with the same issuer the following year. This is intended to address gaming and encourage individuals to maintain continuous coverage throughout the year, which will have a positive impact on the risk pool.

 

Ensure More Choices for Consumers: For the 2018 plan year and beyond, the final rule allows issuers additional actuarial value flexibility to develop more choices with lower premium options for consumers, and to continue offering existing plans.

 

Empower States & Reduce Duplication: The final rule reduces waste of taxpayer dollars by eliminating duplicative review of network adequacy by the federal government. The rule returns oversight of network adequacy to states that are best positioned to evaluate network adequacy.


You left a little out of your post. How come? Go to the bottom of your support and you will find the main reason some states have large increases. Look at the list. They are states who have not or just expanded medicaid. The other thing you left out is the insurers who have tried to blackmail CMS to support their mergers or they drop out. 2 Large ones did that this year. How about the insurers who tried to get large increases from the states and were turned down because what they wanted was not justified, and dropped out. Some of the Blues are an example. You left out in Pa. rates will increase 3% due to a premium assessment by the state to add money to the claims guarantee fund which just about went broke after a large insurer went broke with its long term care insurance and the state is now paying those claims.

Now the changes shown in the main body of the report will help some and basically there is nothing wrong with them, but real savings will not come from them. By the way the changes came from the carriers to CMS as suggestions.

As I have said before you select articles to post in here which you do not fully understand and then want people to discuss them, when what is really needed is a full understanding of the subject so you post something that shows the full program problems and changes needed, and that you have a good understanding of the program. By the way the people on the AARP Staff working in this area do understand the full problem and that is why they can give advice to CMS, and others.

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Valued Social Butterfly
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CMS Issues Final Rule To Increase Choices and Encourage Stability In Health Insurance Marketplace

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Message 12 of 12

These don't fix it but may help.  What do you think?

CMS Press Release on Final Rule to Increase Choices and Encourage Stability in Health care Marketpla...

 

The final rule makes several policy changes to improve the market and promote stability, including:

 

2018 Annual Open Enrollment Period: The final rule adjusts the annual open enrollment period for 2018 to more closely align with Medicare and the private market. The next open enrollment period will start on November 1, 2017, and run through December 15, 2017, encouraging individuals to enroll in coverage prior to the beginning of the year.

 

Reduce Fraud, Waste, and Abuse: The final rule promotes program integrity by requiring individuals to submit supporting documentation for special enrollment periods and ensures that only those who are eligible are able to enroll. It will encourage individuals to stay enrolled in coverage all year, reducing gaps in coverage and resulting in fewer individual mandate penalties and help to lower premiums.

 

Promote Continuous Coverage: The final rule promotes personal responsibility by allowing issuers to require individuals to pay back past due premiums before enrolling into a plan with the same issuer the following year. This is intended to address gaming and encourage individuals to maintain continuous coverage throughout the year, which will have a positive impact on the risk pool.

 

Ensure More Choices for Consumers: For the 2018 plan year and beyond, the final rule allows issuers additional actuarial value flexibility to develop more choices with lower premium options for consumers, and to continue offering existing plans.

 

Empower States & Reduce Duplication: The final rule reduces waste of taxpayer dollars by eliminating duplicative review of network adequacy by the federal government. The rule returns oversight of network adequacy to states that are best positioned to evaluate network adequacy.

* * * * It's Always Something . . . Roseanne Roseannadanna
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