By Eric Gascho, Vice President, Policy and Government Affairs 

On July 28, the National Health Council (NHC) submitted comments on the Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Proposed Rule to the Centers for Medicare and Medicaid Services (NBPP). The NHC is pleased to see that this proposed rule attempts to reverse various regulatory approaches that the NHC previously opposed.  

Our comments specifically focused on the following areas: 

Strengthening Navigation Assistance 

The NHC supports strengthening navigator assistance for patients who need help enrolling or transferring plans within the Marketplace. We believe navigators are a needed resource for patients so they can find a plan that best fits their needs, which is difficult in a complex system. We are pleased to see greater emphasis on this crucial service in the proposed NBPP. We also urged CMS to work with community partners to relay the message of the importance of health care coverage and that assistance is available. 

Section 1332 Waivers and Direct Enrollment 

In previous comments, the NHC “strongly urged CMS to withdraw its proposal to permit states to implement Direct Enrollment mechanisms without submitting an application for a Section 1332 waiver,” and we are pleased to see CMS did precisely that. The withdrawal of this approach will help ensure that patients have the support and information they need.  

Open Enrollment Extension  

The NHC generally supports any proposal that will allow more people to seek coverage in the exchanges. Extending the open enrollment period will give potential enrollees more time to decide what plan works best for them. 

Monthly Special Enrollment for APTC-Eligible Individuals 

The NHC agrees with CMS and their proposal to have a general extension to the special enrollment period for people below 150 percent of the federal poverty level to help increase coverage for those individuals and help them take advantage of subsidies to help them without overburdening the system. As enrollment is expanded, it is important to continuously gauge the impact on any potential increases in risk selection with access and affordability for consumers. The NHC wants to ensure that efforts are made to ensure that healthy individuals enroll to help them prevent diseases and help keep premiums low in the Marketplace.  

Section 1332 Guardrails  

CMS’ proposed rule includes significant clarification of what a state would be required to have in place to ensure that coverage under a 1332 waiver would be equivalent to and what would be offered in place of that waiver. The NHC believes that this clarification is critical, and previous attempts to weaken these guardrails would put the quality of coverage individuals can access at risk.  

For more information, please read our full comments here.