Expanded Consumer Choice Act of 2017

Senator Mark Warner

Co-sponsor: Senator Manchin

The Expanded Consumer Choice Act would create a new coverage option, the Copper Plan,
which would be offered to consumers along with the existing Platinum, Gold, Silver, and Bronze
health care plans. Copper Plans would provide a lower-cost, higher-deductible, federal-assistance
eligible option for consumers, while also covering the essential health benefits and consumer
protections required of all health care plans offered through the Affordable Care Act (ACA).
Under this proposal, individuals would be able to access the health care system through visits to
their primary care physician or their primary care team. These visits would be exempt from cost-
sharing requirements such as deductibles and co-payments.
Background: The ACA included reforms requiring that plans tailor their cost sharing to comply
with four levels of actuarial value (AV), and to cover the Essential Health Benefits. Premium tax
credits are available for individuals with incomes up to 400% of the federal poverty level.
Despite the financial assistance, a less expensive alternative like Copper Plans may better meet
many consumers financial and medical needs. The proposal aims to attract individuals who have
not yet bought coverage through the marketplaces, and young or healthy people who may want a
less expensive option.
The establishment of a standard primary care benefit in Copper Plans would guarantee access to
the health care system for individuals, and serve as a guardrail against illnesses and disease
progression that may lead to costlier care.
The bill: The Expanded Consumer Choice Act would provide a new copper level of coverage
under qualified health plans, designed to provide benefits that are actuarially equivalent to 50%
of the full AV of benefits provided under the plan. It would also require the Secretary of HHS to
create regulations establishing annual limits on deductibles and cost-sharing for copper-level
plans, in order to ensure that the limits are reasonable for every marketplace and to consider the
feasibility of the relative plan design in each local insurance marketplace.