What's next for healthcare marketplaces in U.S. territories?

The future of healthcare marketplaces in U.S. territories remains murky after the Department of Health and Human Services granted them exemptions last month to key provisions of the Affordable Care Act, California Healthline reported.

In a letter sent to Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam and the Northern Mariana Islands, HHS noted that the territories do not have to comply with certain ACA coverage requirements, such as community rating, single risk pool or medical-loss ratio, FierceHealthPayer previously reported. 

Insurers previously pulled out of territories over concerns regarding market stability, especially in territories where the individual mandate didn't apply and policy subsidies weren't available.

Angela Weyne, an insurance commissioner in Puerto Rico, told California Healthline the commonwealth's health insurance system now has more options. The exemptions will allow for more flexibility to make decisions that fit the population's needs, Weyne said. While the exemptions will help Puerto Rico's market, Weyne cautioned that the health insurance providers fee, which still applies to the territories, may drive up premiums. 

Meanwhile, insurance officials in the U.S. Virgin Islands say they won't allow the new exemptions for insurers until HHS provides more clarity, according to the article.

Concern about lack of clarity is nothing new. While state interpretations of provisions like essential benefits vary, insurers tend to disagree about certain health benefit provisions.

For more information:
-here's the California Healthline article