The Trump administration is weighing new ways to spur the sale of health insurance across state lines, a long-held goal of President Trump and congressional Republicans that has so far failed to gain much traction.
The Centers for Medicare and Medicaid Services on Wednesday asked for comment on eliminating regulatory and other barriers that may be discouraging interstate sales, a request that often means guidance or new regulation will follow.
“Americans are in desperate need of more affordable health insurance options,” said CMS Administrator Seema Verma in a statement. She that eliminating barriers to selling insurance coverage across state lines “could help provide access to a more competitive and affordable health insurance market.”
Republicans have argued that interstate insurance sales would heighten competition and lower costs. Mr. Trump identified the sale of insurance across state lines as an important tool while he was on the campaign trail.
But the request for comments released Wednesday could rekindle debate over the concept. States have been concerned that the administration may try to weaken their authority to regulate their own insurance markets.
A provision in the Affordable Care Act already allows such sales through state agreements. Six states have passed laws to set up interstate sales, but no policies currently are being sold.
Barriers include the sheer complexity of insurer regulation. Each state has its own requirements, complicating efforts to make multistate sales work. Any new insurers entering a state also face the formidable task of taking on competitors that already have market share and negotiated contracts with hospitals and doctors.
The administration said Wednesday it is looking at how states can enter into an agreement on interstate sales under the ACA. CMS said it is looking for public comment on how it can expand access to insurance across state lines and the financial impacts of such sales.
The administration, as part of its focus on the issues, has already enabled small companies and the self employed to band together in association plans to buy insurance across state lines.
Some health analysts argue that cross-state sales would do little to drive down prices. Instead, some states have said it would lead to an erosion in covered benefits and consumer protections. Supporters argue it would offer people more choices, especially in areas of the country where there are fewer insurers offering plans.
Efforts to generate interstate sales have been around for more than a decade. More than 20 states have considered related legislation. Republicans including Reps. Fred Upton of Michigan and Marsha Blackburn of Tennessee have also pushed legislation to foster interstate sales.