CMS seeks feedback on selling health plans across state lines

Stack of health insurance application forms with stethoscope on top
CMS wants feedback on selling insurance across state lines. (Getty/vinnstock)

CMS is seeking feedback on ways it can make it easier for payers to sell insurance across state lines.

The Centers for Medicare & Medicaid Services issued (PDF) a request for information Wednesday evening, and in the document the agency said that it’s especially looking for recommendations on how states can take advantage of a regulatory framework in the Affordable Care Act that would allow for plans to be sold across state lines.

The RFI was mandated in an executive order signed by President Donald Trump in October 2017.


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“Americans are in desperate need of more affordable health insurance options,” CMS Administrator Seema Verma said in a statement. “Eliminating barriers to selling health insurance coverage across state lines could help provide access to a more competitive and affordable health insurance market.”

RELATED: How physicians would fare if payers could sell insurance plans across state lines

Republicans have pushed the sale of insurance across state lines as a key way to bring down costs and boost competition. However, some industry groups have been skeptical, as it is easier said than done to ensure the provider network works in multiple regions.

A 2017 fact sheet (PDF) from America’s Health Insurance Plans, the payer industry group, warns that selling plans across state lines could increase administrative work and also segment the risk pool, driving up premiums.

“For example, plans with certain benefit packages sold by out-of-state entities may attract individuals with lower health risks and result in substantially higher premiums for less healthy individuals who remain to purchase coverage within the state,” according to the fact sheet.

The RFI is the latest step under the Trump administration to offer greater choice and alternatives to ACA plans, especially as premiums were on the rise across the country. It expanded the length of short-term plans to 12 months from three, and expanded association health plans as well.

In the announcement for the RFI, the agency touted its work to increase choice, as average premiums for ACA plans declined in 2019 for the first time since they were rolled out in 2014.

The RFI will be open for comments for 60 days.

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