Here are seven considerations:
1. CMS will launch a pilot program to analyze the impact of stricter requirements for consumers buying coverage through the ACA’s public exchanges after the deadline.
2. The government wants to curb the number of consumers opting into the ACA exchanges only after they become sick and require insurance.
3. The ACA prevents payers from barring consumers based on preexisting conditions, so they must accept these already sick patients. This setup leads to high costs for payers and upsets the risk pools.
4. To combat this, CMS included confirmation steps for the special enrollment periods, as well as posted warnings on the exchanges’ websites about penalties for misusing special enrollment periods. Some of the special enrollment periods have also been slashed.
5. Seven weeks after adding this confirmation process, special enrollment period plan selections dropped 15 percent in 2016 compared to the same time period in 2015.
6. CMS plans to use its pilot program to assess if its added measures are impacting “compliance, enrollment, continuity of coverage, the risk pool and other outcomes,” according to a press release.
7. CMS will continue taking suggestions on the pilot program’s structure until Sept. 20.
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