Plan Changes to Expect in 2016 Open Enrollment

The Affordable Care Act sets new standards and requirements for health plans sold through the individual and small group markets, including the law’s marketplaces. The Department of Health and Human Services’ (HHS) Notice of Benefit and Payments Parameters and additional guidance in 2014, 2015, and 2016, have guided these reforms and have had important implications for consumers enrolled in these plans. Chiquita Brooks-LaSure will evaluate the 2016 rule and related regulatory guidance and assess the degree to which federal policy on health plans has changed from the previous two years. The project will then examine how these changes might be expected to improve the actual plans that consumers will purchase in the 2016 open enrollment period. The analysis will then define a framework for policy makers to assess whether these improvements were actually achieved. This framework will help policy makers determine whether the regulatory and plan review process at the state and federal levels are effective in translating the rule into plan improvements, or if different policy tools are needed to ensure that consumers realize the benefits of the federal policy changes. In the event of a ruling in favor of the plaintiffs in King v. Burwell, this project will discuss the likely effects of the decision on 2016 plans.