(In July 7 story, changes paragraph 4 from saying "only" random
checks by health exchanges to random checks in some cases where
By David Morgan
WASHINGTON, July 7 Days after delaying health
insurance requirements for employers, the Obama administration
has decided to roll back requirements for new state online
insurance marketplaces to verify the income and health coverage
status of people who apply for subsidized coverage.
President Barack Obama's healthcare reform law is slated to
begin offering health coverage through state marketplaces, or
exchanges, beginning Oct. 1. But to receive tax subsidies to
help buy insurance, enrollees must have incomes ranging from 100
percent to 400 percent of the federal poverty line and not have
access to affordable insurance through an employer.
Until now, the administration had proposed that exchanges
verify whether new applicants receive employer-sponsored
insurance benefits through random checks. It also sought to
require marketplaces to verify each enrollee's income status.
But final regulations released quietly on Friday by the
Department of Health and Human Services (HHS) give 16 states and
the District of Columbia, which are setting up their own
exchanges, until 2015 to begin random sampling of enrollees'
employer-insurance status. The rules also allow random - rather
than comprehensive - checks on income eligibility in 2014 in
some cases where income cannot be verified electronically
against other data including tax records.
The changes, which point to new technical and bureaucratic
challenges at the state and federal levels, raise new questions
about the how successfully Obama's Patient Protection and
Affordable Care Act will be implemented. The law is scheduled to
go into effect on Jan. 1. But the administration's latest move
acknowledges that exchanges need extra time to get their
verification systems in place.
Less than a week ago, the administration also announced that
it would not require employers with 50 workers or more to
provide insurance benefits until 2015, a one-year delay that
stirred speculation about the possibility of further delays.
The regulations, contained in a 606-page HHS rule, allowed
state-run exchanges to accept an enrollee's "attestation
regarding enrollment in an eligible employer-sponsored plan."
Marketplaces to be operated by the federal government in 34
states will still make random checks to verify applicant
insurance status in 2014, it said.
"For income verification, for the first year of operations,
we are providing (state and federal) exchanges with temporarily
expanded discretion to accept an attestation of projected annual
household income without further verification," the rule said.
(Editing by Eric Walsh)