House Energy and Commerce Committee Chairman Frank Pallone (D-NJ) and Ways and Means Committee Chairman Richard Neal (D-MA) sent a letter to CMS Administrator Seema Verma on Tuesday asking for information on the Trump Administration’s changes to the marketplace enrollment process. They argue that changes that were finalized in April as part of the 2020 Notice of Benefit and Payment Parameters (NBPP) could steer consumers away from marketplace plans, and have asked Verma to respond to efforts to expand direct enrollment and enforcement actions taken against insurers or web-brokers enrolling consumers in these alternative plans.
The committee chairmen are specifically requesting detailed information on changes that could steer consumers into enrolling in non-marketplace coverage plans established by the Trump Administration’s expansion of short-term plans and association health plans. Their letter contends that these plans do not provide comprehensive coverage or guarantee the same consumer protections available through Marketplace plans, to include essential health benefits and the prohibition on preexisting condition discrimination. Their letter also argues that the NBPP adds new barriers for individuals and families eligible for Medicaid or the Children’s Health Insurance Program, and that consumers are less able to compare price and quality metrics of marketplace plans, which may further discourage enrollment.
The NBPP also included provisions that provide greater flexibility for direct-enrollment entities and modified several definitions related to direct enrollment and web brokers. The letter noted concerns with the additional flexibility for consumers to enroll in marketplace coverage through third-parties such as web-brokers or insurers directly, rather than through the marketplace. They argue that this will lead to consumers to not be fully informed about their coverage options.
NAHU has actively worked with both the Obama and Trump administrations on their NBPPs and accompanying letters to issuers that are released ahead of each open enrollment period to ensure they provide adequate consumer protections. We specifically cited concerns with consumer protections in comments that we submitted in February for the 2020 NBPP. We advised CMS to encourage consumers to use a licensed and exchange-certified health insurance agent when purchasing a plan, and noted concerns with their proposal to allow direct enrollment entities to allow unlicensed application assisters to help individuals purchase coverage and apply for premium tax credit subsidies. We also opposed the proposal to allow unlicensed assisters, application counselors and navigators to use web-brokers and direct-enrollment technology to advise consumers about what plan options to select in any way that shows preference to a particular provider or network of healthcare provider entities.