Biden Admin Backs New SEP, but Is Adverse Selection a Worry?

The Biden administration on June 28 made good on its previous pledge to roll back certain Trump-era regulations regarding the Affordable Care Act exchanges when it issued a proposed rule that CMS deemed a “continuation” of the already finalized two-part Notice of Benefit and Payment Parameters for 2022. But the most consequential part of the proposal, experts say, wasn’t a policy reversal so much as a new idea that federal health officials want to try on for size: offering a monthly special enrollment period (SEP) for a select group of individuals.

“To provide more opportunities for certain low-income consumers to access premium-free or very low-cost coverage made available by the American Rescue Plan Act of 2021, we are proposing to provide Exchanges the option to implement a monthly SEP” for people with a household income no greater than 150% of the federal poverty level (FPL), CMS said in a fact sheet outlining the proposed rule’s provisions.

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Leslie Small

Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

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