Washington, D.C. February 15, 2017 – The Trump Administration today announced new proposed rules governing the Affordable Care Act (ACA) that would create roadblocks to purchasing coverage, increase people’s out-of-pocket costs, and make it more difficult for people to enroll in health coverage, according to Families USA, the national organization for health care consumers.
Specifically the new rules would: Discourage younger, healthier people from enrolling in coverage through truncated enrollment periods; reduce financial assistance for lower- and moderate-income families, forcing them into plans with drastically higher deductibles; and make it harder for people to find doctors who take their insurance. The rules would cut the annual Open Enrollment Period (OEP) in half and make it more difficult for people to enroll outside the OEP when they experience life changes, like getting married, having a child, or losing insurance.
“The Trump Administration is deliberately trying to sabotage the Affordable Care Act, especially by making it much more difficult for people to enroll in coverage,” said Ron Pollack, executive director of Families USA. “By making it harder to enroll, they are creating their own death spiral that would deter young adults from gaining coverage, thereby driving up costs for everyone.
“Very significantly, the Administration has completely reneged on its promise to lower deductibles. Instead they are increasing cost-sharing and cutting back financial assistance for coverage.”
Following are the policies being proposed by the Administration, with a brief summary of their potential damage, according to Families USA.
The Proposed Rule: Weaken cost-sharing requirements for Marketplace plans by allowing insurers to sell plans with even lower actuarial values at each metal level. This would allow insurers to sell plans with even higher deductibles than currently permitted. Under this proposed policy, people could easily see their deductibles in a silver plan increase by more than a thousand dollars.
- The Damage: Despite the fact that President Trump said that deductibles are too high, this rule would significantly increase deductibles and reduce the amount of financial assistance lower- and moderate-income people receive by tying that assistance to cheaper silver plans with higher deductibles and cost-sharing. People could choose to pay more in premiums to avoid seeing their deductibles increase, but, either way, their costs will go up drastically
The Proposed Rule: Cut future open enrollment periods in half – from November 1 to December 15, rather than November 1 to January 31.
- The Damage: This drastic cut limits the opportunity for people to take the time to both learn about their various coverage options, and then purchase insurance. And because this timeframe overlaps with the Medicare enrollment period, there will be limited resources for the large number of consumers who need enrollment assistance.
The Proposed Rule: Tighten rules for those enrolling in coverage outside of the Open Enrollment Period when they experience certain life changes, such as getting married, having a child or losing health insurance.
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- The Damage: While less than 5 percent of consumers eligible for special enrollment periods (SEPs) actually enroll, when the rules have been tightened in the past, young adults – the very people who would help balance the risk pool and bring down costs for everyone – were deterred from enrolling due to the cumbersome processes.
The Proposed Rule: Tighten rules around grace periods by scaling back the ACA provision that provides low- and moderate-income enrollees receiving financial assistance a 90-day grace period to pay their premiums.
- The Damage: This change would lead to low-and moderate-income not being able to maintain continuous coverage when they are unable to pay their premium in full.
The Proposed Rule: Eliminates network adequacy standards to ensure enrollees have access to necessary doctors and hospitals, along with essential community provider standards to ensure providers who serve predominantly low-income, medically underserved populations are in network.
- The Damage: Although the insufficiency of provider networks under the ACA is a favorite GOP talking point, this rule will result in narrower, less adequate networks. It will force enrollees to travel farther for care, wait longer for appointments, and choose between forgoing care or paying high out-of-network costs.
Families USA, a leading national voice for health care consumers, is dedicated to the achievement of high-quality, affordable health care and improved health for all.