The Health Insurance Marketplace Prepares for 2015 and Beyond

Posted May 16, 2014
By Mandy Cohen, Director, Center for Consumer Information and Insurance Oversight

Today, we issued a final rule promoting affordability, transparency and taking the first step toward providing additional quality related tools for consumers shopping in the Health Insurance Marketplace.  

We continue to be pleased with the success of the Marketplace in enrolling more than eight million consumers during this first open enrollment period. Building on that success and learning from this historic first enrollment period, the policies released today ensure that consumers, employers, and health insurance issuers have the guidance and information they need to prepare for next year and beyond.

The final rule released today builds on the lessons learned from this year’s first open enrollment period and provides the certainty stakeholders need in order to prepare for next year’s open enrollment period.  Nearly all of today’s policies were previously described in prior rulemaking or guidance.

This rule will help to improve consumer protections, keep premiums affordable, and make additional information available to consumers in the future, such as quality ratings that will help them to better compare and choose plans. 

Specifically, today’s rule finalizes policies to:

  • Strengthen the prescription drugs exceptions process, so consumers with an urgent medical issue have quicker access to needed drugs that aren’t already covered by their plan
  • Require health insurance issuers to provide standardized notices to their enrollees when issuers decide to discontinue or renew coverage
  • Collect information from issuers to generate quality rating scores for plans on the Marketplace beginning in 2016
  • Provide flexibility to states to ensure SHOP works in the best interest of consumers in 2015
  • Strengthen standards for Navigators and other consumer assisters
  • Improve premium stabilization policies for 2015

Together, these policies will build on the consumer protections already in place in the Marketplace, continue to provide states with the flexibility they need to provide health insurance to their consumers, and continue to ensure that all consumers have access to quality, affordable health coverage in 2015 and beyond.

A fact sheet with detailed information on today’s rule can be found here: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/marketstandards-5-16-2014.html

Content last reviewed on May 16, 2014