Publications

Setting the stage for the 2019 Health Insurance Marketplace

April 25, 2018

A screenshot of "Healthcare.gov", a site for the Health Insurance Marketplace.The Centers for Medicare and Medicaid Services is rolling back regulations around rate increases, essential health benefits, health insurance navigators, and more, for insurers offering Qualified Health Plan coverage on the Health Insurance Marketplace in 2019.

On April 9, 2018, the Centers for Medicare and Medicaid Services (CMS) issued new guidance for insurers offering Qualified Health Plan (QHP) coverage on the Health Insurance Marketplace created under the Affordable Care Act. In this guidance, CMS made several important changes intended to provide states with greater flexibility to regulate their individual and small group health insurance markets beginning in 2019.1 

In a new fact sheet, CHRT compares the current rules and regulations to the changes that go into effect in 2019—with a special focus on Michigan. The face sheet reviews essential health benefits, health insurance navigators, maximum out-of-pocket limits, standardized plan options, rate increase reviews, medical loss ratio, risk adjustment, silver loading, individual mandate hardship exemptions, projected premium and federal spending changes, and the timeline for the 2019 filing process in Michigan.

Here are just a few highlights:

  • Rate increases under 15 percent will no longer require review;
  • Simple choice standardized plans will be eliminated; and
  • Consumer cost-sharing limits will increase by 7 percent.

These changes to the 2019 Health Insurance Marketplace will impact Michigan consumers as soon as November 1, 2018, when the next Marketplace Open Enrollment Period begins.

READ THE BRIEF

Update: For more information about the 2019 Health Insurance Marketplace, read our rate analysis.