In Final ACA Exchange Rule, CMS Softens Some Industry-Protested Policies

In response to industry pushback against a proposal that would have significantly limited how many non-standardized Affordable Care Act exchange plans issuers can offer, CMS in a newly finalized regulation opted for a less-restrictive approach — at least for 2024. Yet policy and actuarial experts aren’t convinced that the newly set limits are enough to solve the “choice overload” problem that’s made it increasingly hard for consumers to find ideal coverage.

With its troubled years — and mass insurance carrier exits — largely behind it, the ACA exchange market has become increasingly competitive. On the one hand, that’s good for consumers and the market at large, as research has shown competition tends to push down premiums. But the Biden administration and consumer advocates have also grown increasingly concerned that the proliferation of plan options available to insurance shoppers is making it nearly impossible to differentiate between products and choose what’s right for them. While the average ACA marketplace consumer had 25.9 plans to choose from in 2019, that number rose to 107.7 by plan year 2022, according to HHS. Research, including a 2016 RAND Corp. review of 100 studies, indicates that having too many choices can lead consumers to make poor health insurance enrollment decisions.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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