The Centers for Medicare & Medicaid Services (CMS) has requested public comments on ways to remove barriers to the sale of health insurance coverage across state lines in order to expand consumer choice.  In particular, CMS is interested in how states can utilize Section 1333 of the Affordable Care Act (ACA), which authorizes two or more states to enter into a “Health Care Choice Compact” to allow a health insurance issuer to offer qualified health plans (QHPs) in the individual health insurance market in any state included in the compact.  Under this authority, the QHP generally would be subject only to the laws and regulations of the state in which the health insurance coverage was written or issued.  To date, no states have passed legislation to enter into an ACA Health Care Choice Compact.

In a request for information (RFI) published March 11, 2019, CMS solicits comments on whether and how the Administration should promote the sale of QHPs across state lines through Health Care Choice Compacts.  The RFI seeks input on numerous operational considerations associated with Health Care Choice Compacts, along with the potential impact on consumers and the insurance market.  CMS will accept comments until May 6, 2019.