By NextBestFitPhase 3: Waves 2 & 3: working-age adults · Step 3.5
Close the ACA Marketplaces
End of Year 3 · CMS CCIIO; state exchangesDiscuss this step
Pros & cons of this step
Pros
- +Ends the annual enrollment cycle, subsidy cliffs, and narrow-network plans.
Cons
- −Marketplace navigator and exchange jobs end.
Trade-off behind each cost item
- Payers stop paying this; the money is replaced by the new taxes listed under financing.
- Existing public money keeps flowing, now to UHP instead of separate programs.
Trade-off behind each system change
- ACA Marketplaces (HealthCare.gov and state exchanges)Ends subsidy cliffs and churn; Marketplace staff and navigator jobs end.
- Navigator and enrollment-assistance grantsLess need for enrollment help; community organizations lose a funding stream.
- IRC §36B premium tax creditsEnds complex reconciliation and repayment at tax time.
- ACA cost-sharing reductions & silver loadingEnds a convoluted subsidy mechanism.