Final NBPP 2024 released: Let's see what made the cut...and what didn't.
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law. While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS) Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year. Back in December, CMS released the proposed NBPP for 2024, which included a long list of tweaks & changes (some major, some minor) to how the ACA functions and is administered.
NBPP 2024 Part 5: User Fees, Risk Adjustment, Agents, Brokers & Web Brokers
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS). Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented. Yesterday CMS released their proposed 2024 NBPP, which includes some important changes which, if included in the final version, will go into effect starting next fall (for calendar year 2024). The full proposed 2024 NBPP is actually 370 pages long; yesterday I posted the press release & Fact Sheet. Today I'm breaking it down into smaller chunks since there's a lot to talk about here: FFM and SBM-FP User Fees For the 2024 benefit year, CMS proposes to lower the user fee rate from 2.75% to 2.5% of premium for QHPs sold on the FFM, and to lower the user fee rate from 2.25% to 2.0% of premium for QHPs sold on the SBM-FP.
NBPP 2024 Part 4: Medicaid/CHIP, Special Enrollment Periods, Income Data & Navigator expansion
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS). Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented. Yesterday CMS released their proposed 2024 NBPP, which includes some important changes which, if included in the final version, will go into effect starting next fall (for calendar year 2024). The full proposed 2024 NBPP is actually 370 pages long; yesterday I posted the press release & Fact Sheet. Today I'm breaking it down into smaller chunks since there's a lot to talk about here: CMS proposes that beginning January 1, 2024, that Marketplaces have the option to implement a new special rule for consumers losing Medicaid or Childrenβs Health Insurance Program (CHIP) coverage that is also considered minimum essential coverage (MEC).
@AndrewSprung has a great overview of the meaningfullness of the meaningful difference regulations proposed in
#NBPP2024 https://xpostfactoid.substack.com/p/cms-proposes-cleaning-out-an-augean 
CMS proposes cleaning out an Augean ACA marketplace
Proposed rule would chaos in a market now replete with near-meaningless choices
NBPP 2024 Part 3: Dental Plans, Re-enrollment Hierarchy & QHP Marketing Names
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS). Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented. Yesterday CMS released their proposed 2024 NBPP, which includes some important changes which, if included in the final version, will go into effect starting next fall (for calendar year 2024). The full proposed 2024 NBPP is actually 370 pages long; yesterday I posted the press release & Fact Sheet.
NBPP 2024 Part 2: Standardized Plans & Meaningful Differences!
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS). Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented. Yesterday CMS released their proposed 2024 NBPP, which includes some important changes which, if included in the final version, will go into effect starting next fall (for calendar year 2024). The full proposed 2024 NBPP is actually 370 pages long; yesterday I posted the press release & Fact Sheet.
NBPP 2024 Part 1: Network Adequacy & Essential Community Providers
The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS). Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented. Yesterday CMS released their proposed 2024 NBPP, which includes some important changes which, if included in the final version, will go into effect starting next fall (for calendar year 2024). The full proposed 2024 NBPP is actually 370 pages long; yesterday I posted the press release & Fact Sheet.
#NBPP2024 intends to reduce choice overload possibilities by either making meaningful difference both meaningful and different or using a Standard + 2 choice structure
https://balloon-juice.com/2022/12/13/reducing-choice-overload-on-healthcare-gov/
I'm not sure which one I think is better, but anything that reduces the probability that people face 200+ choices is likely an empirical improvement.
@charlesgaba @LouiseNorris @AndrewSprung @cynthiaccox @onceupona
Balloon Juice - Reducing Choice Overload on Healthcare.gov
Last night, the Centers for Medicare and Medicaid Services (CMS) released the proposed Notice for Benefit and Payment Parameters -2024 (NBPP 2024). The NBPP is an annual rule. It is the rule book for each year of health insurance operations for the ACA individual market. Some years it is big and meaty. Other years it is just β¦
Outcomes After Changes to US Health Insurance Marketplace Automatic Renewal Rules
This economic analysis estimates the extent to which a smart default policy could reduce health insurance marketplace enrolleesβ cost sharing and premiums.
Charles Gaba
David Anderson