CMS Announces Rule Aimed to Reduce Consumer Costs in Health Insurance Marketplace in 2022

The Centers for Medicare & Medicaid Services (CMS) announced today a final rule, the Notice of Benefit and Payment Parameters for 2022, pertaining to insurance marketplaces that “finalizes changes to reduce consumer costs, empower states to develop their own unique plans, accelerate innovation, and clarify program requirements.”

“Since 2017, premiums are down, coverage options are up, and we have stabilized the individual market with better care at lower costs,” said CMS Administrator Seema Verma in a press release. “The actions we’re taking today ensure these improvements can continue tomorrow, because we must never be satisfied when too many Americans still cannot afford coverage in the individual market.”

Specific changes, which are planned to go into effect in 2022, include a 0.75% reduction in user fees for health plans sold through Federally Facilitated Exchanges (FFEs), more flexibility for states to allow the creation of health programs suited to local needs, allowing for the use of web-based brokers to provide insurance, and “Greater clarity on building plans that lack a traditional provider network.” Other provisions allow for the extension of consumer protections for those who seek healthcare under Healthcare Reimbursement Arrangements (HRAs) rather than traditional group health plans.