KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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More Proof Required To Sign Up During Special Enrollment Periods

The Obama administration is tightening the rules about customers entering the federal exchanges after the open enrollment period following an outcry from insurers.

The New York Times: Proof Needed To Enroll In Health Plan Post-Deadline
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 Washington Post: HHS Makes It Tougher To Sign Up For ACA Coverage Outside Of Enrollment Season
Under rules announced Wednesday by the Department of Health and Human Services, people who want coverage under five main reasons for a “special enrollment period” 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)

USA Today: Feds Will Soon Require Proof For Special Obamacare Enrollment Periods
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 —

The Fiscal Times: Obamacare Fraud Is Rampant And Unchecked, GAO Warns
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 “passive approach” to ferreting out potential fraud and often fails to act even when queries made through the hub turns up conflicting information – or no corroborative information at all. (Pianin, 2/24)

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