The Centers for Medicare and Medicaid Services (CMS) released its annual update to marketplaces, which includes many improvements to marketplace coverage for the upcoming 2023 plan year. Some of the most important changes that affect marketplace coverage are:
- Insurance companies can no longer restrict people who owe past-due premiums from enrolling in one of their plans.
- Insurance companies in state-based marketplaces and HealthCare.gov will be required to offer standardized plans wherever they also offer non-standardized plans. Standardized plans make it easier for people to make direct comparisons between different plans offered on the marketplace.
- Insurance plans offered on HealthCare.gov will be required to meet federal standards for network adequacy, to assure that enrollees have timely access to the health care they need.
- Insurers will also be required to expand the proportion of Essential Community Providers (ECPs) in the in-network service area. ECPs include providers like community health centers, safety-net hospitals, and Indian health care providers.
- There will be stronger standards for agents, brokers, and web brokers to ensure they verify application information with the applicant before submitting an application or enrolling a person in a plan.