KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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After Insurer Outcry, Feds Offer Rules To Rein In Special Enrollment Sign-Ups

The government will be taking several steps to prevent consumers from gaming the insurance market by waiting until they are sick before getting coverage under the Affordable Care Act.

The New York Times: U.S. Toughens Rules For Latecomers Trying To Enroll In Health Care Act
The Obama administration, responding to complaints from insurance companies, announced several steps on Tuesday that will make it harder for consumers to obtain health insurance after the annual open enrollment period. ... Kevin J. Counihan, the chief executive of the federal insurance marketplace, said that special enrollment periods “are not allowed for people who choose to remain uninsured and then decide they need health insurance when they get sick.” Mr. Counihan said the administration would eliminate six of the special enrollment periods. ... In addition, he said the government would clarify eligibility standards and step up enforcement to prevent abuse of special enrollment periods. (Pear, 1/19)

USA Today: Feds Tighten When People Can Enroll In Obamacare Plans
Bowing to pressure from insurers, federal officials on Tuesday tightened the conditions under which people can sign up for plans on the exchange outside open enrollment. The move by the Centers for Medicare and Medicaid Services comes after complaints by health insurers that it was too easy for people to wait until they were sick to sign up and to drop coverage after they got treatment. Earlier Tuesday, UnitedHealth announced a 19% drop in profit and downgraded its earnings forecast citing concerns about its Obamacare enrollment and the flexibility people had to change insurance plans. (O'Donnell, 1/19)

The Associated Press: Please Hold: Insurance Customers Begin New Year With Delays
Thousands of health insurance consumers around the country have started the new year dealing with missing ID cards, billing errors and other problems tied to an enrollment surge at the end of 2015. Brokers and insurers in several states told The Associated Press that they've been inundated with complaints about these issues from customers with individual plans and those with coverage through small businesses. Insurance provider Health Care Service Corp., for instance, has been dealing with delays for around 10,000 companies, while billing errors caused bank overdrafts for 3,200 individual customers of a North Carolina insurer. (Kennedy and Murphy, 1/19)

Meanwhile, UnitedHealth is taking steps to pull back on its exchange business after its fourth quarter losses —

The Wall Street Journal: UnitedHealth Raises Forecast For Losses On Affordable Care Act Plans
UnitedHealth Group Inc. said its projected losses on the Affordable Care Act exchanges for 2016 deepened as enrollment grew despite the company’s efforts to reduce sign-ups. UnitedHealth had taken steps to pull back on its exchange business in anticipation of losses, including reducing marketing and slashing commissions to health-insurance agents. But enrollment nevertheless grew, widening the company’s exposure. (Wilde Mathews, 1/19)

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