Health and Science

Trump administration asks for recommendations on reducing Obamacare 'burdens'

Key Points
  • The Centers for Medicare and Medicaid Services wants ideas on how to make the rules about individual and small-group insurance markets more "flexible" and "streamlined."
  • "Our goal ... is to identify and eliminate or change regulations that are outdated, unnecessary, or ineffective," CMS said.
  • The agency has made a series of moves that aim to tweak the Obamacare regulatory structure.
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The woman who oversees Obamacare for the federal government is asking for ideas from the public on how to make that health-care law less of a "burden."

The call for public comment on how to change Obamacare through regulatory moves comes at the same time as the Trump administration continues to push Congress to pass legislation that would repeal and replace key parts of the law.

In a statement, the federal Centers for Medicare and Medicaid Services said the request for information it will issue seeks ideas for how to make the rules about individual and small-group insurance markets more "flexible" and "streamlined."

CMS' release on the request refers to "reducing the regulatory burdens of the Patient Protection and Affordable Care Act," the official name of Obamacare.

"Our goal ... is to identify and eliminate or change regulations that are outdated, unnecessary, or ineffective; [and] impose costs that exceed benefits," CMS said.

As in other recent announcements by Trump administration health agencies, CMS highlighted problems with Obamacare markets.

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The agency noted that people who have obtained health coverage through Obamacare marketplaces "are facing significant premium increases" and are "also dealing with fewer plans to choose from and a continuous stream of" insurers exiting those marketplaces.

CMS Administrator Seema Verma said, "We are looking for valuable feedback on how to change existing regulations in ways that put patients first, promote greater consumer choice, enhance affordability and return more control over health care to the states."

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The request for comment is scheduled to be published in the Federal Register on Monday. Members of the public will be able to make comments online for 30 days.

CMS in recent months has made several other moves to tweak the Obamacare regulatory system. Those changes are not dependent on approval by Congress, which is considering a Republican-backed plan to change Obamacare by law. It is not clear now that the GOP will be able to pass such a plan this year.

In April, CMS issued a final rule that it said will "increase choices and encourage stability in the health insurance market for 2018."

That rule reduced the next annual open enrollment period in Obamacare individual plans by a month and a half. It will now run from Nov. 1 through Dec. 15.

The rule also allows insurers to require customers to pay past-due back premiums before they enroll in a plan with the same insurer the following year, and requires people to submit supporting documents if they seek to sign up for health coverage during special enrollment periods outside of open enrollment.

In May, CMS said it would remove a technical hurdle in how online insurance brokers sign up customers in plans sold on HealthCare.gov, the federal Obamacare marketplace that serves the majority of states.

Also last month, CMS said it would propose that HealthCare.gov stop enrolling people in health plans available for businesses that have 50 or fewer full-time workers. CMS' proposal would allow HealthCare.gov to continue determining the eligibility of businesses for the Small Business Health Options Program. But those businesses would have to buy coverage for their workers from an insurance agent or broker, or directly from an insurance company.

Although CMS has said it wants to encourage stability in the insurance market, critics of the Trump administration have accused it of trying to sabotage Obamacare markets.

On Thursday, the insurance commissioner of Washington state said the administration and Congress have eroded confidence among the nation's insurers by calling for a repeal of Obamacare, and for refusing to guarantee billions of dollars in federal payments to insurers for key subsidies to low-income customers. Washington is losing two insurers in its Obamacare markets next year, and will see the number of individual health plans available to customers cut by more than half.

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