Morning Briefing
Summaries of health policy coverage from major news organizations
More Proof Required To Sign Up During Special Enrollment Periods
People who want to buy health insurance in the federal marketplace outside the annual open enrollment period will now have to provide documents to show they are eligible, the Obama administration announced on Wednesday. In the last two years, insurers say, many people went without coverage and then signed up under the Affordable Care Act when they became sick and needed care. Insurers say that people who sign up after the deadline tend to generate more claims and more costs, raising premiums. (Pear, 2/24)
The new measures are a response to criticism from insurers who have said people are abusing a rule that lets consumers enroll in insurance through the federal marketplace, HealthCare.gov, outside official sign-up periods if they meet certain criteria. (Armour, 2/24)
Under rules announced Wednesday by the Department of Health and Human Services, people who want coverage under five main reasons for a 鈥渟pecial enrollment period鈥 will need to supply documents proving that they deserve an exception from the regular sign-up times. The new requirement will be for people in the 38 states that rely on the federal insurance exchange who need to begin or change coverage because they have moved, had a baby, adopted a child, gotten married or lost other health coverage. (Goldstein, 2/24)
The federal government is tightening loopholes that let customers on the Affordable Care Act's public insurance exchanges buy coverage outside the law's annual enrollment window. That could ease a major concern health insurers have about the exchanges. (Murphy, 2/25)
It addresses complaints from insurance companies that the Centers for Medicare and Medicaid Services was allowing too many people to buy insurance after the open enrollment deadline passed. This, insurers said, left them with many consumers who waited until they were sick to sign up and then dropped coverage after they received treatment. And the companies claim that created a sicker-than-expected pool of customers that was contributing to the losses on Affordable Care Act exchange plans. (O'Donnell, 2/24)
In other news, the Government Accountability Office warns about the administration's lax efforts in ferreting out fraud on the Affordable Care Act's data services hub聽鈥
A new report issued Wednesday by the U.S. Government Accountability Office found that even with tens of billions of dollars in subsidies costs at stake, the Obama Administration has taken a 鈥減assive approach鈥 to ferreting out potential fraud and often fails to act even when queries made through the hub turns up conflicting information 鈥 or no corroborative information at all. (Pianin, 2/24)
