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Tuesday, Jan 12 2016

Full Issue

Enrollment Rules To Tighten In Effort To Crack Down On ‘Bad Actors’

Insurers have complained that people are waiting to sign up on the exchanges until they are sick, which is driving premiums skyward. The Obama administration announced Monday it will eliminate or rework language to fight those who are taking advantage of the system.

The Obama administration will tighten the rules for people who enroll in insurance through HealthCare.gov outside of official enrollment periods, hoping to hold down costs that insurers blamed on late sign-ups. A top federal health official said Monday that the administration will eliminate some criteria for late sign-ups and make other criteria language clearer. Insurers say that the rules are so broad that people can wait until they get ill to buy insurance. That raises health-care spending and overall premiums because people who are sicker generally cost more to cover. (Armour and Radnofsky, 1/12)

Obamacare customers are gaming the system, buying coverage only after they find out they’re ill and need expensive care — a trend insurers warn is destabilizing the fledgling health law marketplaces and spiking premiums for everyone. Insurers blame the problem on lax rules that allow more than 900,000 people to sign up for coverage outside the standard enrollment season — for instance, when they change jobs or move — without sufficient proof they are eligible. (Demko, 1/12)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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