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Commissioner Lara asks Trump Administration to withdraw proposed changes that ‘wreak havoc on the Affordable Care Act’

News: 2019 Press Release

For Release: February 19, 2019
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Commissioner Lara asks Trump Administration to withdraw proposed changes that ‘wreak havoc on the Affordable Care Act’

SACRAMENTO, Calif. — Today California Insurance Commissioner Ricardo Lara urged the Trump Administration to withdraw proposed rules that could “wreak havoc on the Affordable Care Act,” making health care harder to access or more expensive for some Californians.

Commissioner Lara’s letter to the Centers for Medicare & Medicaid Services, Department of Health and Human Services came in response to the Trump Administration’s proposed changes to federal regulations referred to as the Notice of Benefit and Payment Parameters, which relate to the Affordable Care Act. 
“Certain provisions of the proposed Notice of Benefit and Payment Parameters for 2020 threaten the financial security and health of Californians and others throughout our nation,” wrote Commissioner Lara. “In previous years, annual changes to federal regulations made in the Notice of Benefit and Payment Parameters have not been used as an opportunity to wreak havoc on the Affordable Care Act. These proposed regulations include a number of provisions that would be destructive to health insurance markets and could cause Californians and those throughout the country to lose their coverage or find it unaffordable. I urge you to withdraw the portions of these proposed regulations that make such significant and harmful changes.”

Read Commissioner Lara’s full letter

Key issues:

  • The proposed regulations seek comment on “Silver Loading”, a practice that California and many other states have utilized since the federal government stopped making the cost-sharing reduction payments (CSRs). Premiums in Silver health plans sold through the exchanges in some states include the CSR amounts; this results in higher premium subsidies for eligible individuals buying through the exchanges, while permitting policies sold outside the Exchange to avoid inclusion of the unpaid CSR amounts. This acts to keep the cost of insurance coverage and the out-of-pocket costs affordable. 
  • The proposed regulations propose to eliminate auto re-enrollment. Auto re-enrollment has been the practice since 2014. Doing away with it will cause confusion and will cause some people to lose coverage.
  • The proposed regulations would require insurers selling through the Exchange to sell products that exclude abortion coverage, but otherwise mirror their products that include coverage for abortion, if permitted by state law. In states that don’t require coverage for abortion services, this proposal could result in the insurer removing abortion coverage from all of their health insurance policies, rather than finding another way to comply with this onerous anti-choice requirement. 


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Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state’s consumers by fairly regulating the insurance industry. Under the Commissioner’s direction, the Department uses its authority to protect Californians from insurance rates that are excessive, inadequate, or unfairly discriminatory, oversee insurer solvency to pay claims, set standards for agents and broker licensing, perform market conduct reviews of insurance companies, resolve consumer complaints, and investigate and prosecute insurance fraud. Consumers are urged to call 1-800-927-4357 with any questions or contact us at via webform or online chat. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.

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