The Obama administration announced new tools on Wednesday to verify people who want to sign up for Obamacare year-round, the same day the agency was criticized for not fully vetting Obamacare enrollees.
The tool would be for people applying for a special enrollment period, which is for people who need a change in healthcare coverage after the open enrollment period. It applies only to those who sign up through healthcare.gov, which covers about 38 states.
The verification process now includes additional documentation to prove individuals’ eligibility for the periods, which are usually reserved for those who lose their job or get married or divorced.
The process comes at a time when the insurance industry has been complaining about the special enrollment periods. When Obamacare launched, there were enrollment periods for people confused about the enrollment process and so on.
Insurers are worried because someone could enroll in Obamacare when they get sick and drop out when they get better, causing premiums to rise.
The Centers for Medicare and Medicaid Services recently reduced the number of special enrollment periods to acknowledge the problem.
Now it is going a step further with the additional requirements.
The change applies to five commonly used special enrollment periods: loss of minimum essential coverage, permanent move, birth, adoption and marriage.
“We are committed to making sure that special enrollment periods are available to those who are eligible for them,” said Kevin Counihan, the CEO of healthcare.gov. “But it’s equally important to avoid misuse or abuse of special enrollment periods.”
The new tools didn’t get plaudits from the pro-Obamacare advocacy group Families USA, which thought the new requirements would burden enrollees.
“We should be making it easier for people to sign up for health insurance, not harder,” said Rachel Klein, director of organizational strategy for Families USA. “If there is a problem with special enrollment periods, let’s design solutions that don’t add a lot of red tape that keeps eligible consumers from getting the coverage they need.”
The decision to boost verification requirements came the same day a federal watchdog criticized CMS for not fully verifying the identification of Obamacare enrollees.
The Government Accountability Office found that one-third of 2014 Obamacare applicants had unverified identification. The GAO found that the administration’s system for detecting fraud wasn’t being fully implemented or used.
The report included an update on an undercover investigation in which officials bought Obamacare online or by the phone. Eleven fake enrollees were able to fool Obamacare officials by sending in fake documents or no documents at all when requested, and they still got healthcare coverage.
