03 May 2017

CMS and the Health Insurance Market

CMS and the Health Insurance Market

There will be a few changes to the Obamacare insurance marketplace in 2018, thanks to new rules and regulations passed about the Affordable Care Act and the nationwide health insurance marketplace. The Centers for Medicare and Medicaid Services, or CMS, have issued their own regulations to hopefully help stabilize the market in the coming years.

CMS has issued their final rule, called the Market Stabilization Rule. The CMS, a federally funded and run body, hopes that this action will help keep premiums from spiking, stabilize individual and small group markets, and increase the number of health insurance policies that are available through the marketplace.

Stabilizing the marketplace

The Affordable Care Act destabilized the health insurance industry in the United States. By creating the marketplace, thousands of insurance agencies around the country now offer insurance policies that millions of previously uninsured individuals could afford. This increased the amount of money coming into the insurance industry and spread the overall risk around to multiple competing insurance entities.

The Affordable Care Act has continued to offer millions of previously uninsured people health insurance options, but many insurance providers backed out of the insurance marketplace. Unable to meet the demand or come up with new policies, the marketplace has remained unstable and prices on premiums are likely to continue increasing.

The Centers for Medicaid and Medicare Services are doing their best to continue offering affordable health care options for people who qualify. Small steps like the Market Stabilization Rule will hopefully help the marketplace regain stability in the short-term, although greater problems in the American health care industry still very much exist.

Other changes

In addition to lowering premiums, the CMS has made the open enrollment period for health insurance in 2018 shorter. The annual open enrollment period will last between November 1, 2017, and December 15, 2017.

If people are unable to enroll during this period, there will be stricter rules regarding supporting documentation and people who qualify to enroll in the marketplace outside of the open enrollment period. The rule also encourages individuals with past due premiums to pay back that money before they enroll in a new health insurance plan with the same agency they had before.

The CMS also hopes to widen the range of health insurance policy plans that are available in the insurance marketplace. They hope to give more power to states that are able to regulate their own health insurance markets to decrease duplications in plan offerings.

Short-term solutions

Although these aspects of the CMS ruling are admirable and may help stabilize the market in the next few years, over time these regulations aren’t enough to fix the marketplace and the issues that exist in the Affordable Care Act. Most policy makers and insurance agents realize that there is a lot more that needs to be done in relation to the health care industry to fix the problems that are inherent in the system that has been created.

In the meantime, the regulations imposed by the government and the CMS will hopefully fix the market temporarily.

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