Shares of insurers were mixed in the early afternoon on Wednesday with Aetna gaining 1 percent to $127.01, Cigna off less than 1 percent at $146.07 and Humana off 0.3 percent to $205.34. Anthem fell less than 1 percent to $162.90.
Tougher to Enroll
The Centers for Medicare and Medicaid Services, which are part of the Department of Health and Human Services, on Wednesday proposed the new rule that includes verifying the status of enrollees outside of the usual enrollment period.
It also proposes insurers can collect unpaid premiums from members when they sign up with the same issuer again, an incentive for people to always have insurance.
In addition, it proposed lowering the amount of guaranteed coverage for some “silver” level plans in the program, which it said could raise out-of-pocket spending and cut premiums.
It would give the states oversight of doctor and hospital networks included in the plans, reflecting a Republican theme that healthcare oversight be reduced at the federal level.
The rule proposes shortening the open enrollment period for the individual market to Nov. 1 through Dec. 15, similar to employer-sponsored insurance market and Medicare.
The weakening of the mandate and the new CMS rule making it tougher for people to sign up would have contradictory effects on premium pricing, according to Jonathan Gruber, professor of economics at MIT and one of the architects of the Affordable Care Act.
“You’re basically saying on the one hand, we have to weaken the mandate for political reasons but we have to lower prices, so we have to kick people out of the exchanges,” Gruber said.
Patient advocate Families USA said the new rules would discourage younger, healthier people from enrolling, reduce financial assistance for families and make it harder for them to find networks that include their doctors.
Republican lawmakers, who are working on an Obamacare replacement, said the rule was a start.
“If we don’t take more steps like that, having an Obamacare subsidy will be like having a bus ticket in a town where no buses run, because there will be zero choices to buy,” Senator Lamar Alexander, chairman of the Senate health committee, told reporters outside the Senate.
Wall Street said the proposed changes could help insurer profitability but it was not clear by how much.
“As one would expect tightening special enrollment periods, shortening the open enrollment period to six weeks and mandating payment of premiums before coverage should lead to an improvement in the risk pool,” Leerink Partners analyst Ana Gupte said.