Thank God for small favors: CMS may kick some NBPP changes down the road another year or two

Last month I posted a massive 3-part series of articles which looked at nearly 3 dozen changes being proposed by the Trump Regime's Centers for Medicare & Medicaid Services (CMS) to how the Affordable Care Act will be administered starting this fall (for the 2027 plan year).

The changes ranged from the mundane (for instance, one provision simply says that the per enrollee user fees paid by insurance carriers to HHS to pay for HealthCare.Gov's operations will remain the same as they are this year) to the devastating (up to 1.5 million legally-present immigrants who were previously eligible for ACA tax credits, including victims of domestic abuse and human trafficking, either already are or will soon become ineligible for financial assistance).

Most are somewhere in between.

In the end, over 2,800 public comments were submitted in response to these proposed changes, and while my guess is that most of the ugliest changes are still going to go through regardless, it looks like some comments did have some impact on how CMS plans to proceed.

via Amy Lotven of Inside Health Policy:

CMS officials told state insurance regulators over the weekend that some of the bigger proposals in the draft 2027 exchange rule are on a longer trajectory, indicating they will not be finalized this year.

...The draft rule wasn’t released until Feb. 10 with comments due March 13, and insurers are slated to begin submitting their qualified health plan (QHP) applications April 15.

...CMS proposes...that catastrophic plans could create multi-year contracts lasting up to 10 years, and issuers could apply cost-sharing requirements in the contracts, pro-rated monthly.

CMS also proposed allowing plans that don’t have networks but pay a fixed rate for a service to be certified as a qualified health plan as long as the plan can show patients have access to a range of providers that accept the plans’ rates as payment in full.

The draft rule would also require states to defray the cost of any mandated essential health benefits, implement several eligibility verification requirements, allow states to adopt decentralized exchanges, and more.

...[Some] ideas are viewed as medium-term proposals, “so we’ll see what we can do this year and then no doubt there will be more to come in years to come,” said an official. So, CMS may not “lock up” every issue that was raised in the draft rule as that would be very difficult to do under the existing timelines, and so the aim is to be realistic, the official added.

Notably, the American Academy of Actuaries in its comments recommended CMS delay several of the proposals, including those related to catastrophic plans and plans without networks.

We'll see what actually ends up making the cut and what gets bumped out another year or two....hopefully most of it.