Mandate against 'silver loading' not likely during next ACA enrollment

Alex Azar testified about HHS priorities in front of the U.S. House Committee on Education and the Workforce on Wednesday. (CSPAN)

Health and Human Services Secretary Alex Azar said Wednesday there wouldn't be enough time to mandate against insurer so-called silver loading on Affordable Care Act marketplaces before the next enrollment season.

Azar was testifying about HHS' priorities when Rep. Joe Courtney, D-Conn., told him about concerns raised by industry leaders in states like Connecticut over the question of whether silver loading would be allowed.

"The issue you’re raising is whether the impact of the so-called silver loading would be put across bronze and gold plans as well, not just silver plans," Azar said. "That would actually require regulations that simply couldn’t be done in time for the 2019 plan period."


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As The Advisory Board explained earlier this year, silver plans were used as the benchmark plans on individual insurance marketplaces under the ACA. As premiums increased on silver plans, the subsidy for consumers generally increased about the same amount.

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After the Trump Administration canceled the ACA's cost-sharing reduction payments to insurers last year, state officials allowed insurers to make up the loss by loading their cost increases to the silver plans. With only a few weeks from the 2019 rate-setting process for many states, the biggest question mark is whether insurers would be forced to "broad load," or spread their rate increases.

In April, The New York Times reported Centers for Medicare & Medicaid Services Director Seema Verma indicated in a call with reporters that the Trump administration was considering banning the practice of silver loading.

During Wednesday's hearing, Azar went on to say it's not clear whether broad-loading would ultimately be good for the market or consumers and called it "a facile question." But Courtney said the issue is on the minds of plenty of insurers.

RELATED: Eyes on the unsubsidized: With no shield from rate hikes, some face unaffordable plan options

"We’re weeks away from the 2019 rate-setting process," Courtney said. "You occupy the decision-making process which will determine whether rates are going to go up by double digits or not."

Azar responded again there wouldn't be enough time to regulate such an issue before the enrollment period on the ACA marketplaces, which will run from Nov. 1 through Dec. 15.

"I’m going to take that as a no and hopefully that message gets out to regulators across the country," Courtney said.

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