On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
Understanding the Potential Role Web Brokers Can Play in State-Based Marketplaces
Manatt Health Solutions – Joel Ario and Allison Garcimonde, and Wakely Consulting Group – Jon Kingsdale
The Affordable Care Act (ACA) is already greatly expanding individual health insurance coverage, particularly among lower-income uninsured individuals. However, this is neither easy nor inexpensive to sustain, and it will require ongoing, effective public-private partnerships on multiple levels. One potential partnership opportunity is with “web brokers” who sell individual health insurance online, functioning as private distribution channels in a fashion similar to the new Marketplaces and offering a choice of health plans from multiple insurers, while relying primarily on websites and call centers for customer service. This brief, prepared by Manatt Health Solutions and Wakely Consulting Group, seeks to understand the role that web brokers might occupy in this continuously developing landscape, and is intended as a tool for State-Based Marketplaces (SBMs) to investigate potential opportunities for partnerships with these entities. An executive summary of this issue brief provides an overview of this topic, including descriptions of five leading web brokers, a summary of the evolution of federal policy on web brokers, and potential SBM approaches for contracting with web brokers.