The Trump Administration Marketplace Rule—and How States Can Respond

In April 2017, the Department of Health and Human Services (HHS) finalized a rule creating sweeping changes to health insurance marketplaces. Many of these changes could make it more difficult or more expensive for consumers to enroll in coverage. Fortunately, states have options at their disposal to reduce the harm caused by this rule and create policies that are more consumer-friendly in nature. Some of these policies can be adopted by any state, including those with federally facilitated marketplaces (FFMs), while other options can only be adopted in state-based marketplaces (SBMs).

This brief provides an overview of state options related to open enrollment periods, special enrollment periods, policies for consumers who owe past premiums, actuarial value and affordability of plans, network adequacy, and essential community providers.