The new rules also changed the minimum number of prescription drugs that must be offered in each drug class. The new proposed rule says that the number of drugs in each class should match that in each state's benchmark plan, but should be at least one.
Prior administration documents suggested that one drug per class would meet the requirement in all states—an issue for some patients who aren't always helped by that drug and require alternatives.
The rules were distributed in three primary documents totaling 334 pages.
The Obama Administration's representatives made clear that it is ready for 2014, and will have plans and states prepared to open up exchanges for consumer enrollment by Oct. 1, 2013.
"Absolutely, we will be ready," said Gary Cohen, director of the HHS's Center for Consumer Information andInsurance Oversight. "There will be an exchange in every state open for business on Oct. 1, whether it's a state exchange or the federal exchange."
But America's Health Insurance Plans (AHIP) President and CEO Karen Ignagni indicated insurers have concerns.
"While additional flexibility on essential health benefits (EHB) is a positive step, we remain concerned that many families and small businesses will be required to purchase coverage that is more costly than they have today,” Ignagni said. That and the gradually increasing rates associated with the new age rating rules "may incentivize young, healthy people to wait to purchase insurance until they are sick or injured, driving up costs for everyone with insurance."