Section 1557 and Medigap

[axeman462]

I have been hearing some rumblings about ACA section 1557 possibly being implemented on Medicare Supplements effective January 1 2025.

Supposedly, if the rumors are true, Medigap carriers will not be able to discriminate on age, sex, and UW will be out the window. Essentially GI for all business.

Again, effective January 1, 2025.

It is almost impossible to find any info on this. But I have been able to find some. It appears to be pending.

If this is approved, it sounds like its going to blow up the medsupp market.

Does anyone know anything more about this, or if its actually true?

 

[Fisher]

If this is approved, it sounds like its going to blow up the medsupp market.

Gee... ya think?

 

[Medicare bro]

All the med supp agents on here. Hi Maim I know I told you med supp is the way to go butttttt, I think you should switch over to an MAPD.

 

[Sam]

I wrote about it here, reading the NAIC minutes is very scary

 

[axeman462]

why does our government hate the senior population so much?

 

[Yagents]

Court injunction, it's been delayed, and I assume it applies to Med supps too
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but progress is delayed by federal courts. Just before the new regulations’ effective date, three federal courts put various provisions on hold, with one order applying nationwide. This post describes provisions of the new regulations and explains the recent court orders delaying implementation.

New Regulations Counter Discrimination in Health Coverage and Care but Are Delayed by Courts

New federal regulations expand protections against discrimination under the ACA, but it’s unclear when — or whether — these regulations will take effect.

www.commonwealthfund.org

 

[axeman462]

from @Sam post, pg 7 of the PDF (emphasis mine):

4. Discussed the Impacts of Section 1557 of the ACA and the Application of Nondiscrimination Rules to Medigap

Brian Webb (NAIC) said the final Section 1557 rule was published on April 26, 2024, and it prohibits discriminationon the basis of race, color, national origin, sex, age, and disability. He said the big difference with this new rule isthat it applies to all carrier plans that receive money from the federal government. He said the scope is muchbroader. For example, if a carrier receives ACA funding, it would apply to all the plans it offers, including Medigapplans, excepted benefit plans, and short-term, limited-duration (STLD) plans. He said the effective date generallyis July 5, but the NAIC is most concerned about the provisions for plan years beginning on or after Jan. 1, 2025.

Webb said regulators are considering the rates and designs for these plans and are approving these plans for sale,reissuance, or renewal after that date. Regulators are receiving questions from carriers as to how these various provisions apply to plans beginning next year, such as asking if they cannot discriminate based on age. They are asking if they can rate based on age after that initial period, or if they can rate based on health status, such as adisability, or if they can rate based on gender. They are asking if the rule means they can have a plan that only provides benefits to those over 65.


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The interesting thing here is that it appears it will not apply to carriers that offer only medsupp and not MAPD and PDP.
For example, maybe a P&C carrier like State Farm, or a smaller insurer such as Wellabe.

 

[Yagents]

Allstate is another. Talk about creating a bifurcated market

 

[axeman462]

Allstate is another. Talk about creating a bifurcated market

omg... Bankers Life and Casualty...