Implementing New Private Health Insurance Market Rules

With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. These regulations deal with aspects of the ACA intended to promote broader risk pooling, prohibit discrimination based on health status, enhance insurance market efficiency and affordability, promote wellness, and improve consumer protections.

The brief explains the key provisions in each regulation and notes where there are outstanding issues as stakeholders comment on the rules. It also examines areas where the regulations seek to balance trade-offs  and how these choices may impact consumers.

Issue Brief (.pdf)