CMS BLOGhttps://www.cms.gov/blog/
October 31, 2019By Seema Verma, Administrator, Centers for Medicare & Medicaid Services
HealthCare.Gov Open Enrollment: Lower Premiums, More Choices, Easier to Compare
I’m excited to share the steps we’ve taken to lower premiums, offer more options, and make it easier to compare choices this HealthCare.gov Open Enrollment season. Today marks the beginning of the Open Enrollment period for the 2020 Plan Year on HealthCare.gov. From now until December 15, consumers can log on to HealthCare.gov and CuidadodeSalud.gov, or call 1-800-318-2596, to enroll in a health plan for coverage in 2020.
Current enrollees who don’t update their application and enroll in a plan by the December 15, 2019 deadline will be automatically enrolled in their same plan, or another plan with the same issuer intended to be as similar as possible. If that’s not available, they will be enrolled in another plan with a different insurance company. Consumers who miss the deadline to re-enroll in a plan of their choice during Open Enrollment will also not be able to make any plan changes until the next coverage year, unless they qualify for certain Special Enrollment Periods.
Providing More Options
Faced with serious problems – premiums doubling in price and insurers fleeing the market – President Trump took action by issuing an Executive Order directing the administration to give states more flexibility to stabilize their healthcare markets. In response, CMS quickly issued regulations and guidance that increased competition and choice, lowered costs, and gave more control back to states, allowing them to innovate and advance their own solutions.
And it’s worked. I’m pleased to report that consumers coming to HealthCare.gov to buy coverage will find lower premiums and more choices for the second consecutive year. The average premium for the second lowest cost silver plan on HealthCare.gov for a 27-year-old will drop by 4 percent[i] next year. Also, more issuers will be offering coverage on HealthCare.gov, bringing the total number to 175 issuers, compared to 132 in 2018.
Ahead of Open Enrollment, users were able to preview these changes to plans and prices. On October 25, 2019, CMS launched updates to window shopping, which allowed consumers to preview 2020 plans and prices without logging in, creating an account, or filling out the official application.
Lower premiums and more choices will likely be the most obvious improvements consumers see when they come back to HealthCare.gov, but they are by no means the only ones. This year CMS is rolling out a number of new features and enhancements to help consumers choose the coverage that’s right for themselves and their families.
Driving Quality Transparency
To help consumers when they’re comparing health coverage choices, we’re excited to announce that for the very first time, HealthCare.gov will display quality rating information in all states that use HealthCare.gov. Under our 5 star Quality Rating System, Exchange health plans will have an overall rating on a 1 to 5 scale, with 5 stars representing the highest quality. When consumers view the list of plans available in their area, the ratings will be automatically displayed. The overall star rating is based on three categories: Medical Care, Member Experience, and Plan Administration. In a few cases, such as when plans are new to the Exchange, ratings aren’t available. Quality ratings give consumers a snapshot of how an Exchange plan compares to others in their state. For more information, please see the Exchanges Quality Rating System fact sheet.
Improving Users’ Shopping Experience
HealthCare.gov consumers will also benefit from a new visual experience when previewing plans and shopping. Based on consumer research and feedback, we’ve refreshed how consumers compare and enroll in plans on HealthCare.gov.
Many consumers around the country will have access to Enhanced Direct Enrollment (EDE) throughout the entire Open Enrollment Period for the very first time. This key development allows CMS to partner with the private sector to provide more avenues for consumers to apply and shop for coverage. The EDE pathway gives consumers the option to enroll in an Exchange plan directly through an approved issuer or web-broker without going through HealthCare.gov or contacting the Exchange Call Center.
Introducing a New Option to Finance Enrollees’ Care
Finally, new rules released this year permit employers to fund individual market premiums for their employees through Health Reimbursement Arrangement (HRA) plans that meet certain requirements. HRAs are employer-funded accounts from which employees are reimbursed, tax-free, for qualified medical expenses. CMS is adding educational information and a consumer worksheet tool to HealthCare.gov to assist employees in determining whether to use an HRA from their employer to help pay for individual market coverage.
Don’t Wait; Act Now
I strongly encourage consumers to update their information, shop, and pick a plan that suits their healthcare needs before the deadline on December 15. Since day one, the Trump Administration’s goal has been to ensure that all Americans have access to affordable, quality health coverage. Combined with our improvements to the market, the updates to HealthCare.gov will make for a better consumer experience with more choices.
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