Trump administration creates new exemptions under ACA mandate

The Centers for Medicare and Medicaid Services, headed by Seems Verma (R), rewrote Affordable Care Act rules to create new exemptions under the laws mandate among other changes. File photo by Mark Wilson/UPI

April 10 (UPI) — The Trump administration rewrote rules regarding health care plans sold through Affordable Care Act marketplaces Monday, providing new exemptions to the law’s individual mandate.

The rules administered by the Centers for Medicare and Medicaid Services allow individuals in counties where no insurers or only one insurer is selling plans in the marketplace to qualify for a “hardship exemption” from paying the fine for lacking insurance.

People who oppose abortion, but live in counties where the only available plan covers abortion services can also qualify for the exemption.

“Too many Americans are facing skyrocketing premiums that they can’t afford, and every year consumers are faced with the threat of fewer choices. This rule gives states new tools to stabilize their health insurance markets and empower citizens to find coverage that fits their families’ needs and budgets,” CMS Administrator Seema Verma said.

The rules will take effect for ACA plans to be sold this fall for 2019 coverage, before Congress’ repeal of the individual mandate goes into effect on Jan. 1.

Another change provides states with more flexibility to change the Essential Health Benefits, a list of health services insurance plans must cover.

“Instead of being limited to 10 options, states will now be able to choose from the 50 EHB-benchmark plans used for the 2017 plan year in other states or select specific EHB categories, such as drug coverage or hospitalization, from among the categories used for the 2017 plan year in other states,” the CMS said.


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