On June 8, 2017, CMS issued a statement (available here) announcing a request for information (RFI) seeking recommendations and input from the public “on how to create a more flexible, streamlined approach to the regulatory structure of the individual and small group [health insurance] markets.”

Earlier this year, President Trump directed HHS and other agencies with responsibilities under the Affordable Care Act (ACA) to:

• Provide relief from any provision or requirement of the ACA that would impose a fiscal burden on any State or impose a cost, fee, tax, penalty, or regulatory burden on individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products, or medications; and
• Provide greater flexibility to States and cooperate with them in implementing health care programs; and encourage the development of a free and open market in interstate commerce for the offering of health care services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.

According to the RFI, the following steps have been taken to accomplish these goals, including:

• Issuing the Market Stabilization Final rule on April 18, 2017, which contains regulatory changes intended to stabilize the individual and small group health insurance markets;
• Proposing new health coverage enrollment options for small businesses enrolling through the Federally-facilitated Small Business Health Options Program;
• Announcing a new streamlined and simplified direct enrollment process for consumers signing up for individual market coverage with the assistance of web-brokers or issuers in States with Exchanges that rely on HealthCare.gov for their eligibility and enrollment functions;
• Issuing guidance to States encouraging innovative approaches that would lower premiums and protect consumers via State innovation waivers under Section 1332 of the ACA;
• Extending the HHS Risk Adjustment and Data Validation (HHS-RADV) pilot by another year;
• Adjusting the QHP certification calendar, to provide issuers additional time to prepare and States additional time to review 2018 products and rates with greater certainty in response to recent policy changes; and
• Allowing patients to keep their transitional individual and small group insurance plans in 2018.

Now that these steps are complete, CMS is seeking innovative ideas from consumers in order to “identify and eliminate or change regulations that are outdated, unnecessary, or ineffective; impose costs that exceed benefits; or create inconsistencies that otherwise interfere with regulatory reform initiatives and policies.”

Specifically, the RFI seeks recommendations for changes to regulations and guidance, as well as other actions within the agency’s purview, that would further the following goals:

• Empowering patients and promoting consumer choice;
• Stabilizing the individual, small group, and non-traditional health insurance markets;
• Enhancing affordability; and
• Affirming the traditional regulatory authority of the States in regulating the business of health insurance.

CMS will publish the RFI today in the Federal Register, with comments due July 12, 2017 (docket CMS-9928-NC). The RFI is available here.