Here are five highlights:
1. The rule addresses many payers’ complaints about consumers abusing special enrollments in ACA exchanges.
2. In the rule, CMS changed rules around moving to a new home to make them more restrictive.
3. Co-ops may seek outside funding from investors to increase their capital.
4. CMS’ rule goes into effect May 11, and the agency will accept comments through July 5.
5. Of the ACA’s 23 co-ops, 12 have closed. Most co-ops did not have high enough premiums to sustain themselves.
In the rule, CMS stated, “In the absence of additional federal loans to co-ops, many of these entities would benefit from the infusion of private capital to assist them in achieving long-term stability and competitive success in the market.”
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