Nevada requested a one-year adjustment from 80 percent to 72 percent. HHS granted the one-year modification, but at 75 percent. Two of the state's biggest insurers might have left the market if they had to meet the 80 percent standard right away, HHS said, potentially leaving more than 20,000 people without coverage.
HHS has now granted three adjustments to the new rules. It previously accepted Maine's request for a modified standard, following a lengthy back-and-forth in which some state-level regulators said the department was asking for too much data. They worried that the department's rigorous process might discourage other states from seeking adjustments.
The HHS official said the department has had productive exchanges with the states seeking modifications.
"It's gone smoothly," the official said. "It's been a very good process."
The official could not provide a timeline for decisions on the handful of adjustment applications that are still pending.