States Receive Clarity, Flexibility on ACA with New Rules

According to the Wall Street Journal, the Obama administration has issued new rules to implement several key provisions of the healthcare reform law, which has given states some additional discretion over plans sold within their borders.

The rules underscore that consumers who get health insurance through the Affordable Care Act will see their plans vary from state to state. The Journal explains that, for example, the rules would let states choose whether to ban insurers from taking into account consumers' tobacco use when setting prices for their policies. Additionally, the federal government expanded requirements for prescription-drug coverage from previous proposals, but it left states with different options to choose from, as well as responsibility for enforcement.

 

Our perspective: The new provisions have been met with a fair share of acclaim and criticism. Some patient advocacy groups expressed displeasure, in part because they believe the new rules, such as coverage requirements and age-rating restriction, may make it too expensive for young patients to get coverage. That, they argue, could drive up costs: "Both of these provisions may incentivize young, healthy people to wait to purchase insurance until they are sick or injured, driving up costs for everyone with insurance," said the American Health Insurance Plans’ CEO, Karen Ignagni.

Others have praised them, such as the American Cancer Society, which has said that states’ ability to drop the smoking surcharge will encourage smokers to get the treatment they need, including help quitting.

Overall, there is still plenty to evaluate as we push forward to 2014 when the law’s full effects are felt. But as the weeks go on, states, consumers, and insurers alike should expect state-by-state implementation to vary widely.