On December 26, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services (HHS) quietly issued an informal request for information (RFI) with significant implications for Medicare and Medicaid.
The basis of the RFI is an October 2017 Executive Order (EO) which largely focuses on “promoting healthcare choice and competition” in the private commercial insurance market. In part, the EO directed the Departments of Treasury, Labor, and HHS to expand the availability of association health plans (AHPs), short-term limited duration insurance (STLDI), and health reimbursement arrangements (HRAs). It also directed HHS to produce a report identifying “the extent to which existing State and Federal laws, regulations, guidance, requirements, and policies” limit choice and competition.
The ASPE RFI was issued to inform this report and to “lay the groundwork for future action.” Notably, the RFI dramatically expands the EO’s private market scope by asking about “barriers to choice and competition” within Medicare and Medicaid. These are the only two programs specifically named in the RFI’s five questions, all of which are framed to gather input on how Medicare and Medicaid laws, regulations, and policies could be revised to better align with the administration’s priorities. The questions are available here.
Comments are due January 25. The Medicare Rights Center will be providing input, and we encourage all stakeholders to weigh in as well.
In addition to responding to the substantive issues raised in the RFI, we plan to address the manner in which it was released. By classifying this important feedback opportunity as “informal,” ASPE was not required to comply with the public notice requirements that are part of the standard federal rulemaking process. As a result, we are concerned the RFI may not receive the broad attention and meaningful input needed to constructively inform both the HHS report and the administration’s resulting Medicare and Medicaid policy actions.