Insurance Market Reform

In this FAQ on states’ involvement in plan management activities, HHS establishes that states can evaluate whether health plans and issuers meet certification standards and conduct other specified plan management activities without submitting a Blueprint.

HHS released its final rule on insurance market rules and rate view. This rule establishes an age-rating band of 3-to-1 for adults, which means that the rates for older adults cannot be higher than three times the rate being charged to younger adults, and HHS states it does not have the authority to phase-in this rating band. It also details the catastrophic plan available to younger adults and establishes the protections for individuals with pre-existing conditions.

This white paper from the Kaiser Family Foundation examines the various insurance market changes that may affect health insurance premiums for people buying nongroup insurance when the Affordable Care Act is fully enacted in 2014, including the higher level of benefits, the better protection against catastrophic costs, and wider access to coverage.

The Centers for Medicare and Medicaid Services (CMS) released proposed rules explaining the ACA’s shared responsibility provision and the process for determining eligibility for and granting certificates of exemption from the shared provision.

The Internal Revenue Services (IRS) released proposed rules explaining the ACA’s shared responsibility provision and the process for determining eligibility for and granting certificates of exemption from the shared provision.