HHS proposal prioritizes ACA plan comparison and health equity: 5 things to know

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A rule proposed by the HHS aims to make it easier for consumers to compare ACA market health insurance plans and promote health equity.

The rule, if approved, would go into effect in 2023, according to a Dec. 28. Press release.

Five impacts:

1. The rule would require all insurers using a federal or state market on the federal platform to offer standardized plan options for all types of network, metal, and plan. This decision aims to promote uniform cost-sharing structures to make it easier for consumers to compare plans.

2. HHS aims to reinstate grid adequacy reviews in states with federally facilitated markets. Examinations would track time and distance to care, as well as other measures such as wait times.

3. Under the proposed rule, 35 percent of essential community providers in a coverage area should be connected to the network. The rule also includes substance use disorder treatment centers as essential community providers.

4. The rule again prohibits insurers from discriminating on the basis of gender independence or sexual orientation. The clause was removed in 2020.

5. The proposal changes the policy of non-discrimination of essential health benefits to require clinical evidence as a central part of the design of the regimen.


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