Federal health officials are taking steps to make it harder for consumers to obtain insurance coverage under the Affordable Care Act after the government's enrollment deadline, according to a report from The New York Times.
Here are six things to know about the steps.
1. Federal health officials are not allowing special enrollment periods "for people who choose to remain uninsured and then decide they need health insurance when they get sick," Kevin Counihan, CEO of the federal insurance marketplace, said Tuesday, according to The New York Times.
2. In total, federal health officials plan to cut six out of several dozen special enrollment periods, including two for certain lawfully present noncitizens who experienced "system errors" and "processing delays" when they used the federal health insurance exchange website HealthCare.gov, according to the report.
3. At the same time, the report notes, the government is promising to clarify eligibility standards and strengthen enforcement to prevent abuse of special enrollment periods. For instance, President Barack Obama's administration said it will ensure consumers who have recently moved can only use a special enrollment period if they are planning to permanently relocate, according to The Hill.
4. According to The New York Times, federal health officials appear to be tightening rules for special ACA sign-ups for several reasons:
- To drive consumers to sign up for insurance coverage by the Jan. 31 deadline
- To prevent an influx of large numbers of sick people from entering the market in the middle of the year
- To convince insurers to enter or stay in the public insurance marketplace
- To minimize rate increases in 2017 and beyond
5. The federal government's steps come after complaints from insurance companies. Insurers have contended consumers have signed up late for insurance coverage when they become sick and need care, and this drives up costs for people who sign up during the regular open enrollment period, according to The New York Times.
6. The insurance industry acknowledges the newest steps being taken as an important jumping off point, but it is not completely satisfied, according to The Hill. With the newest steps, The Hill notes, federal health officials would still allow people with an "exceptional circumstance," such as a serious medical condition, to sign up after the deadline. "While this is an important first step, more needs to be done to validate special enrollment requests. It's critical that there is a process in place to avoid potential abuse of special enrollment periods in order to ensure a stable, affordable market for consumers," Clare Krusing, a spokeswoman for America's Health Insurance Plans, wrote in a statement, according to The Hill.
More articles on healthcare finance:
For-profit hospital stock report: Week of Jan. 11-15
MedPAC approves 340B payment proposal: 3 things to know
8 recent hospital outlook and credit rating actions