HHS Proposes Automatic Re-Enrollment for Federal Exchange
On Thursday, HHS announced that most U.S. residents who have health coverage through HealthCare.gov could automatically be enrolled in their existing plan next year, cutting the need to fill out a new coverage application form through the website, the New York Times reports (Pear, New York Times, 6/26).
Federals officials said they are trying to replicate the renewal process that a majority of U.S. workers with employer-sponsored coverage experience annually. They added that about 95% of current HealthCare.gov enrollees could qualify for automatic re-enrollment if they do not change their coverage plans proactively (Radnofsky, Wall Street Journal, 6/26).
While the automatic re-enrollment feature is designed for the federal health insurance exchange, it also could apply to state-run insurance exchanges, officials said. State officials will also have the option to submit an alternative renewal proposal (O'Donnell, USA Today, 6/26).
Automatic Re-Enrollment Feature Details
In new guidance and a proposed rule, HHS said that notices would be sent out to enrollees about the automatic renewal features for their coverage and premium subsidies (New York Times, 6/26).
While the proposed re-enrollment process would be automatic, consumers would be urged to re-evaluate their coverage benefits and needs during the next open enrollment period (HHS release, 6/26). In addition, enrollees would receive information about how to move forward if their incomes or other life circumstances have changed, which could affect their eligibility for future tax credits.
Under the Affordable Care Act, an exchange applicant qualifies for a tax subsidy if he or she has an income up to four times the federal poverty level. Enrollees are required to update their information online when they have a change in income or life circumstances, like marriage or the birth of a child, the Times reports.
Under the proposed rule, if enrollees' incomes increase to more than five times the FPL and they do not proactively change their plan, they would be automatically re-enrolled and their subsidy would be eliminated. Subsidy payments also would stop on Dec. 31 if an enrollee fails to authorize HealthCare.gov to obtain updated tax information from the Internal Revenue Service (New York Times, 6/26).
Some observers say the automatic re-enrollment feature could help discourage a large portion of current enrollees from dropping out of coverage. Caroline Pearson, a vice president at Avalere Health, said HHS is "trying to reduce disruptions in the marketplace by basically allowing people to do nothing and stay insured," adding, "That avoids having people inadvertently fall out of coverage."
According to Modern Healthcare, HHS drafted the proposed rule with input from the National Association of Insurance Commissioners and other stakeholders. The rule is open for public comment for 30 days, after which HHS will issue a final rule (Demko, Modern Healthcare, 6/26).
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