As debate continues over the future of the Affordable Care Act (ACA), the House has held hearings on four piecemeal bills aimed at making incremental changes to the ACA:
- The State Age Rating Flexibility Act of 2017 would expand permissible age rating bands to 5:1 (currently 3:1) under the ACA or a different ratio adopted by the state.
- The Plan Verification and Fairness Act of 2017 would prohibit insurers from making coverage effective for new enrollees who enroll during a special enrollment period (SEP) for plan years beginning on or after January 1, 2018, until the U.S. Department of Health & Human Services (HHS) has verified the individual’s eligibility. This would provide for a process similar to the review and assessment process outlined in the preface to the final Notice of Benefit and Payment Parameters for 2017, but would extend the current pilot to all SEP applications. It is not clear if eligibility determinations would continue to be retroactive. The bill directs HHS to create an SEP eligibility verification process through interim rulemaking.
- The Health Coverage State Flexibility Act of 2017 would reduce the current 90-day grace period for those individuals receiving Advanced Premium Tax Credits (APTC) who miss premium payments to the time period established by state law, or one month for plan years beginning in 2018.
- The Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017 would maintain—though in a more limited manner than under the ACA—a ban of preexisting condition clauses and a requirement for guaranteed availability in the individual and group markets if the ACA is repealed and prior law is restored. Underwriting of premiums would be allowed and it appears that there would be a continuous coverage requirement to be eligible for these protections.