Trump administration starts to chip away at ACA regulations

Signs saying healthcare reform
CMS announced on Tuesday that it had released guidelines to help states seek waivers to exempt them from certain ACA requirements. (Getty/Eugenia)

In a flurry of recent announcements, the Trump administration is starting to wield the power of regulation to minimize the use of Healthcare.gov, and more generally, lessen the influence of the Affordable Care Act.

Starting in the next open enrollment period, consumers who use an approved third-party website to enroll in ACA exchange plans will be able to finish the enrollment process through that website, rather than being redirected to Healthcare.gov to finish their application, according to new guidance (PDF) released by the Centers for Medicare & Medicaid Services on Wednesday.

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Consumer feedback indicated that the redirect process confused potential enrollees and made it more difficult for them to finish their applications, a CMS announcement states.

“It is common sense to make it as simple and easy as possible for consumers to shop for and access health coverage,” CMS Administrator Seema Verma said in the announcement. “It is time to get the federal government out of the way and give patients the best tools to make their own healthcare decisions.”

The move comes just days after CMS announced that it will propose a revamp of how the Small Business Health Options Program (SHOP) marketplaces operate. Under the new plan, employers and employees would go directly through an agent, broker or health insurer to enroll in coverage, rather than Healthcare.gov. States that set up their own SHOP marketplaces, though, would still be able to use them for online enrollment purposes.

In addition, CMS announced on Tuesday that it had released guidelines to help states seek waivers to exempt them from certain ACA requirements. The goal is to encourage states to “pursue solutions to help lower costs and increase coverage choices for Americans struggling with unaffordable premiums and reduced competition in the insurance market, brought on by the ACA.”

In particular, CMS wants to encourage states to complete waiver applications that allow them to establish high-risk pools or state-operated reinsurance programs. The agency cites Alaska as an example of a state that successfully created a reinsurance program to mitigate potentially massive premium increases on individual market plans, noting that it has applied for a waiver to continue that program.

“State initiated waivers that implement high-risk pool/state-operated reinsurance programs will help lower premiums, stabilize the health insurance exchange, and meet the unique needs of each state,” Verma said.