CMS to scrutinize premium subsidy eligibility, expands contraception exemptions
- CMS said Wednesday it intends to "strengthen oversight" of federal subsidies used to lower healthcare costs for some who buy coverage through the Affordable Care Act exchanges. The agency said the proposed rule will ensure that state-run exchanges are correctly determining eligibility.
- To achieve this, CMS said it would revise the the periodic data matching requirements to ensure eligibility. Also, when abortion coverage is offered, CMS said issuers will have to send a separate bill to consumers reflecting the portion of premiums attributable to those services.
- Also Wednesday, the administration issued two final rules expanding religious and moral exemptions for providing contraceptives.
CMS Administrator Seema Verma said the the proposed rule for the exchanges is focused on making sure taxpayer dollars are spent appropriately. Yet, the administration did not offer any details on whether this has been a problem in the past and, if so, what the scope of the issue is.
"Maintaining a high level of program integrity on the Exchange is essential, including ensuring that premium tax credits only go to those who are eligible for them," Verma said in a statement.
On Twitter, Former CMS Administrator Andy Slavitt said the there's "nothing wrong" with trying to make sure tax dollars are spent appropriately. "Government always has to make a trade off between preventing fraud & how much to hassle people," he posted Wednesday.
However, requiring carriers to send a separate bill for the amount of premium that covers abortion services "is being done to show that taxpayer funds aren't being used but likely creates an incentive not to cover abortion services," Slavitt said.
That and a similar final rule would exempt employers from covering contraception if they have a moral objection.
Nicholas Bagley, a law professor at the University of Michigan, said the rules will likely continue to face legal challenges.
"In any event, litigation over the validity of these rules is sure to continue. Both the cases enjoining the prior rules are now on appeal, but I expect they'll be returned, one way or another, to the district courts," Bagley said on Twitter.