Trump's HealthCare.gov Team Drafts Invitations for 2019 Plans

Managers of HealthCare.gov are acting on the assumption that the Affordable Care Act public exchange system will still be selling individual and small-group health insurance coverage in 2019.

The agency that runs HealthCare.gov posted a draft letter to 2019 HealthCare.gov plan issuers Monday.

The agency, the Center for Consumer Information and Insurance Oversight (CCIIO), also posted a draft description of the health plan rate filing deadlines for 2019 individual and small-group plans, and a proposed 2018 filing deadline summary sheet.

HealthCare.gov should continue to work pretty much the same way in 2019, officials say.

If the draft schedule is correct:

Issuers will apply to file applications for 2019 plans from May 9, 2018, through June 20, 2018.
The 2019 plan rates will be due July 25, 2018.
The 2019 rates will go live on the RateReview.HealthCare.gov website Aug. 1, 2018.
The open enrollment period for 2019 individual major medical plans will start Nov. 1, 2018.

In several places in the draft letter for 2019, officials suggest that readers can get more information by looking in the 2018 letter.

Samara Lorenz, the director of the CCIIO oversight group, is listed as the author of the draft description of the rate filing deadlines for the 2019 plans. She has also taken responsibility for sending out similar notices for CCIIO since at least 2015. President Trump

President Donald Trump has proposed repealing and replacing the Affordable Care Act, but he has not talked directly about the future of the ACA public exchange system.

Many of the Republican proposals for changing or replacing the current ACA major medical insurance rules and programs would leave the exchange system in place. The Affordable Care Act: A Brief History

The ACA created a system of "health insurance exchange" programs, or web-based health insurance supermarkets, in an effort to make buying individual and small-group commercial health insurance as easy as buying a book from Amazon.com.

Exchange programs began selling coverage Oct. 1, 2013, and the first policies sold took effect Jan. 1, 2014.

HealthCare.gov (Image: Centers for Medicare and Medicaid Services)

(Image: Centers for Medicare and Medicaid Services)

Drafters of the ACA assumed most states would run their own exchange programs.

The U.S. Department of Health and Human Services (HHS) set up HealthCare.gov to provide ACA exchange plan enrollment and account administration services for states that were unwilling or unable to set up their own ACA exchange programs. HealthCare.gov now runs or supports the public exchange programs for 39 states.

The Centers for Medicare and Medicaid Services (CMS) is the HHS division in charge of HealthCare.gov and other ACA rules and programs that affect the commercial health insurance market.

CMS set up CCIIO to take charge of running the ACA commercial health insurance programs and enforcing the ACA commercial health insurance rules. Proposed 2019 Changes

CCIIO says it will probably eliminate the current effort to require that any new HealthCare.gov plans introduced in a market be meaningfully different from other plans already available in the same market.

Some health policy watchers say offering too many choices can confuse consumers, but CMS officials argued in a draft 2019 parameters notice that HealthCare.gov is now suffering from having too few choices in many markets, not too many choices.

CCIIO also wants to change the threshold it uses to determine when a health plan issuer must explain a premium increase.

In the past, issuers had to explain any increase 10%. Starting in 2019, CCIIO may increase the increase explanation threshold to 15%.

CCIIO says it will also try to make life easier for the web brokers that want to help customers apply directly for Affordable Care Act advance premium tax credit subsidies when buying exchange plans, and to make life easier for the agents and brokers that use the web brokers' direct enrollment systems.

CCIIO will let the web brokers choose the outside entities that decide whether the agents and brokers are qualified to use the direct enrollment process, officials say.

Letting an outside entity decide whether producers are ready to use the direct enrollment system should reduce the regulatory burden on those producers, officials say.

—Read Trump's CMS Posts Draft 2019 Health Insurance Rules on ThinkAdvisor.

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