CMS Releases Final Market Stabilization Rule

May 2017 ~

CMS published a final rule intended to help improve the risk pool and stabilize the Affordable Care Act (ACA) insurance exchanges for 2018.

Under the final rule, the annual open enrollment period is shortened from three months to six weeks. The enrollment period for 2018 is set to begin on November 1 and will run through December 15. According to CMS, this change will help encourage individuals to enroll in coverage prior to the beginning of the year.

The rule also includes stricter requirements for special enrollment periods in which individuals will have to provide supporting documentation for special enrollment periods outside of the annual sign-up period. CMS anticipates the tighter requirements “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.”

To encourage individuals to maintain continuous health insurance coverage throughout the year, individuals will be required to pay overdue premium payments before enrolling in new coverage with the same insurer.

The final rule intends to give insurers more flexibility in deciding how much of consumers’ costs to cover.


Source(s): MGMA Washington Connection; HealthAffairsBlog; Becker’s Hospital Review; FierceHealthcare; Federal Register;