Here are four takeaways:
1. The current ACA requirements say the sickest customers should pay no more than three times the premium amounts than the youngest policy holders pay. However, AHIP proposes modifying that three-to-one ratio to a five-to-one ratio.
2. In the proposed changes, AHIP is asking the government to add fraud prevention costs to the ACA minimum medical loss ratio.
3. AHIP also proposes a stricter requirement on those who can participate in the special enrollment period.
4. Sen. Chris Murphy (D-Conn.) claimed the special enrollment allows people who don’t qualify for SE to enroll, and these people are often the sickest and cost payers the most money.
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