Trump Administration Proposes Individual Market Stabilization Rule

February 17, 2017

The Department of Health and Human Services published a proposed rule to curb exchange abuses and increase carrier flexibility one day after Humana announced it would drop out of the ACA exchanges, Molina Healthcare blamed the ACA for its $91 million fourth quarter loss, and Aetna's CEO Mark Bertolini said the ACA is in a "death spiral" that's "not going to get any better."  The proposed rule is in response to concerns raised by America's Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association of America to the Trump Administration.  According to Molina CEO J. Mario Molina, "We continue to advocate for measures that the federal government can take to level the marketplace playing field for insurers.”  Specifically, the proposed rule would: 
  • Require all individuals looking to enroll in coverage after the ACA's open-season period to provide documentation proving they're eligible before coverage takes effect; and 
  • Allow insurers to slightly increase out-of-pocket costs, but not on the most popular ACA "silver" level plans.
The proposed rule is the first of many the Trump Administration could issue under EO 13765 "to minimize the unwarranted economic and regulatory burdens" of the ACA.