Health and Science

HHS calls for slew of Obamacare rule changes

The Obama administration late Friday called for numerous significant changes to rules controlling the Obamacare health care program, including ones that would shorten open-enrollment seasons, increase transparency of insurance plans and prices, and push current customers toward lower-cost plans.

Most of the new rules proposed by the Health and Human Services Department would go into effect in 2016 if they are approved.

The extensive proposed changes were outlined by a six-page fact sheet distributed by HHS, containing 35 different individual explanations of the suggestions. The proposals themselves are 324 pages long.

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"It is one of our many goals to strengthen the integrity of programs that fall under the Affordable Care Act to ensure the delivery of quality care with affordable options," said Marilyn Tavenner, administrator of the federal Centers for Medicare and Medicaid Services, the HHS division that oversees Obamacare.

CMS, in a press release announcing the proposed changes, said, "Taken together, we believe these policies will ensure that consumers have access to high-quality, affordable health insurance. The rule takes steps to help consumers keep their premiums low."

President Barack Obama
Jim Watson | AFP | Getty Images

The announcement comes just one week into Obamacare's second open-enrollment season, which is set to run through Feb. 15.

One of the rules calls for open enrollment for health insurance plans that will go into effect in 2016 to to begin Oct. 1, 2015, and run through Dec. 15 of that same year. That would mean a sign-up season two weeks shorter than the current season.

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Another proposal calls for having Obamacare customers be "defaulted" to a lower-cost insurance plan instead of their current plan.

"Under current rules, consumers who do not take action during the open enrollment window are re-enrolled in the same plan they were in the previous year, even if that plan experienced significant premium increases," CMS said.

"We are considering alternative options for re-enrollment, under which consumers who take no action might be defaulted into a lower-cost plan rather than their current plan."

Although CMS said it is considering allowing state-run Obamacare exchanges to implement that default option in 2016, the agency is eyeing using that option on the federal Obamacare exchange starting only in 2017.

While the defaulted option could protect customers from sticker shock once their now-pricier plan renews, the option also increases the likelihood that people will find themselves in a plan that doesn't include their preferred doctors or hospitals.

Automatic renewal is currently a concern among Obamacare advocates, who worry that people will end up staying in plans that are too expensive for them, or which do not give them the most value for federal subsidies that help them pay their premiums.

CMS said the proposed rules would also add provisions to "facilitate public access to information about rate increases and small group markets for" individual health plans.

"It also proposes provisions to further protect against unreasonable rate increased in the individual and small group markets," CMS said.

Holding onto healthcare
Holding onto healthcare

One of the proposals would require that all government-run Obamacare exchange, individual insurance plan issuers and web-based insurance brokers "provide telephonic interpreter services in at least 150 languages," CMS said., which sells insurance in the 37 states not running their own exchanges, already meets that standard in its own call center, the agency said.

The agency also wants insurance providers to list all current medical providers in their plan networks on the insurer's public website, update that list monthly, and not require visitors to have an account or policy number to view the list.

Another change would compel insurers to submit information "about all rate increases in the individual and small group markets . . . on a uniform timeline," instead of the current system where states have a variety of deadlines for proposed rates submissions.

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One set of rule changes would replace the standards for how many drugs insurers must include in their list of covered prescriptions, require insurers to have updated, accurate and complete lists of covered drugs, and would require insurers to provide most drugs at retail pharmacies instead of only through mail order.

In a guidance released Friday, HHS said that a person can claim, on their tax return, a hardship exemption from Obamacare's requirement that a person had health insurance if that person during 2014 lived in a state that did not expand its Medicaid program to allow enrollment by individuals earning below 138 percent of the federal poverty level.

The proposed rule changes can be read in full here.

The FAQ sheet on the proposed changes can be read here.

-By CNBC's Dan Mangan