By Bob Herman and Paul Demko, Crain News Service
WASHINGTON (Dec. 31, 2014) — The Centers for Medicare & Medicaid Services (CMS) has run into widespread opposition to a proposal that would change health plan re-enrollment on the insurance exchanges to route those being automatically re-enrolled into less-expensive insurance plans.
In November, the government suggested that consumers who don't shop for a new plan be placed into policies that have lower monthly premiums. Under Obamacare's current policy, health plan members are automatically re-enrolled in their same plan.
“Because we believe that many consumers place a high value on low premiums when selecting a plan, we believe that consumers could benefit from alternative re-enrollment hierarchies,” Health and Human Services (HHS) said at the time.
But many in the industry, especially health insurers, urged the CMS http://www.cms.gov/ to not adopt that change in comments to the agency. Blue Shield of California said people don't buy a health plan on cost alone. They value other elements such as the provider networks and brand. Focusing automatic re-enrollment only on the price of premiums would “drive a race to the bottom,” the insurer said.
“We would remind HHS of the consumer concerns focused last year on the ability of consumers to keep their plan if they like it,” wrote Andy Chasin, an executive at Blue Shield of California. “This policy would run exactly counter to that promise.”
The American Hospital Association (AHA) similarly cautioned that automatically re-enrolling exchange members into low-cost plans could alter desired provider networks.
“Maintaining access to preferred providers is critically important for some plan enrollees, often more important than the premium level, especially for those engaged in ongoing care,” AHA Executive Vice President Rick Pollack wrote. “Any set of hierarchies must clearly articulate the options that best ensure the enrollee will retain access to his/her existing providers.”
Even consumer advocacy groups were wary of the CMS defaulting exchange enrollees into lower-cost plans.
“We recognize that there needs to be a default process for auto-renewing,” said New Hampshire Voices for Health. “However, giving people the choice of being defaulted into a low-cost plan a year ahead of time does not address the critical need to develop effective ways to encourage consumers to play an active role in evaluating their plan choices each year.”
Overall, the CMS received more than 300 comments from various healthcare companies, groups and people on the proposed rule. The agency is expected to issue final 2016 marketplace rules next year.
This report appeared on the website of Crain's Modern Healthcare magazine, a Chicago-based sister publication of Tire Business.