Special enrollment rules will be tightened to help control costs, Andy Slavitt, acting administrator of CMS, said Monday at a J.P. Morgan healthcare conference, according to The Wall Street Journal.
According to the report, payers are blaming those who sign up for insurance on HealthCare.gov outside of enrollment periods for rising costs, saying the special enrollment rules are broad enough people can wait until they get sick to enroll, which drives up healthcare costs.
Mr. Slavitt said the administration plans to eliminate some of the eligibility criteria for special enrollment and it has created a task force to make sure people have legitimate reasons for signing up outside of normal enrollment periods, according to the report.
Almost 950,000 Americans signed up for coverage on HealthCare.gov outside of the enrollment period last year, though half did so because they lost their health insurance, according to the report. Special enrollment criteria include marriage, divorce, job changes or a new baby. Consumer groups are pushing for pregnancy to be an exception, according to the report.
Some of the reprieves that will be axed are those that were offered because the exchanges and enrollment periods were new. For example, those who say they learned about the penalty for not having insurance when they filed for their taxes will not be given an additional opportunity to enroll, according to the report.
HHS said any changes made will not impact open enrollment, according to the report.
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