Consumers will more easily find affordable healthcare coverage in 2023, thanks to the Biden-Harris administration’s December 2021 Notice of Benefit and Payment Parameters 2023 Proposed Rule, according to the U.S. Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS). The rule also improves shopping for healthcare coverage, establishes rules to ensure people have access to care, and advances health equity for consumers purchasing Marketplace coverage.
“With this proposed rule, we are working to ensure the Marketplaces are a model for accessible, affordable, inclusive coverage—particularly for eligible individuals who have thought comprehensive coverage was out of reach,” CMS Administrator Chiquita Brooks-LaSure said.
CMS reported that the proposed rule will:
- Advance standardized plan options by requiring all issuers in the federal Marketplace and state-based Marketplaces on the federal platform to offer standardized plan options for every product network type, level of coverage, and plan classification, as well as in every service area where the issuer will offer Marketplace plans.
- Implement network adequacy reviews to help ensure consumers have better access to the right provider or facility at the right time and in an accessible location, highlighting key characteristics like time and distance to care and appointment wait times.
- Strengthen access to essential community partners for low-income and medically underserved consumers and add substance use disorder treatment centers as eligible essential community providers.
- Prohibit discriminatory practices based on sexual orientation and gender identity and refine health plan designs with clinical evidence.
- Reduce healthcare costs and further streamline Marketplace operations, including scaling back pre-enrollment verification for special enrollment periods.
“We are building a more competitive, transparent, and affordable healthcare market,” HHS Secretary Xavier Becerra said. “At the end of the day, health care should be a right for everyone, not a privilege for some.”