Dive Brief:
- Acting administrator of the Centers for Medicare and Medicaid Services, Andy Slavitt, announced Monday the Obama administration would be restricting special enrollment in ACA health plans due to insurer's reports of abuse of the system.
- Insurers had argued special enrollmnt was so broadly attainable that significant numbers of people were waiting until they got sick to purchase plans, thereby driving up costs.
- Slavitt said the administration planned to eliminate some of the qualifications for late enrollment and to clarify some of the criteria that was being interpreted too broadly. Specific details were not announced.
Dive Insight:
The administration's goal is to make sure special enrollment is utilized as originally intended, Slavitt said, adding both the administration and healthcare consumers are still learning and adjusting.
The tighter control won't stop just at restricting qualification criteria.
As a result of insurer feedback, the administration has created a task force to help verify late enrollment eligibility, Slavitt said, and it has already terminated coverage for some late enrollees who were found to lack true qualification for special enrollment.