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HHS Releases Final Rule Intended to Lower Premiums and Stabilize ACA Marketplace

On Behalf of | Apr 19, 2017 |

HHS has issued a final rule intended to implement certain changes that insurers contend are necessary to help lower premiums and provide stability to the Affordable Care Act individual health insurance marketplace.

Final Rule. The final rule implements certain policy changes intended to enhance the marketplace and promote stability, including:

  • 2018 Annual Open Enrollment Period. The 2018 open enrollment period is shortened and now more closely aligns with the open enrollment periods for Medicare and the private market. The 2018 open enrollment period will run from November 1, 2017 through December 15, 2017 (rather than January 31, 2018), thereby encouraging individuals to enroll in coverage before the beginning of 2018.
  • Special Enrollment Periods. Individuals must provide supporting documentation for special enrollments, ensuring that only those who are eligible are able to enroll. Consumers previously had the option to self-attest to their eligibility for special enrollment.
  • Payment of Past Due Premiums. Insurers may require individuals to pay outstanding premiums owed for coverage provided during the prior 12 months before enrolling in coverage for the next year without violating the guaranteed availability guidelines.
  • Increase Consumer Choice. Insurance issuers have been given additional actuarial value flexibility to develop more low-cost choices and continue offering existing plan options to consumers.
  • Certification of Network Adequacy. The final rule defers to states to certify whether a plan sold in the marketplace meets network adequacy requirements.

The final regulations are available at: