HHS Official: Fewer Will Be Able To Enroll At HealthCare.gov Outside Enrollment Periods

Date: January 13, 2016

Agency To Reduce Scope For Special Enrollment Categories

The Wall Street Journal reported that the Obama administration is planning to narrow the scope of acceptable reasons for insurance enrollment at HealthCare.gov outside of official enrollment periods, according to Andy Slavitt, acting administrator of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services. Insurers said the rules for special enrollment periods were too broad, allowing individuals without coverage to wait until they became ill to enroll in an Obamacare health insurance plan. Because sick people usually have higher medical costs, the current rules increased overall insurer payouts and forced them to increase premiums for their entire risk pool. Slavin attributed the need for the reforms to “bad actors” who took advantage of the current rules. He added, “It’s critical to enforce the integrity of the open enrollment period.” Currently, people can enroll outside of open enrollment under 33 categories of special circumstances, such as if they can demonstrate qualifying life events such as marriage, divorce, employment changes, or the birth of a child.

What This Means To Small Businesses

The administration’s action to tighten special enrollment period criteria is good news, because their abuse increases costs for the system as a whole. While the administration characterized the move as prompted by the learning curve during the transition to the new system, it highlights the ponderousness of the government-driven Obamacare system, which poses an impediment to small business growth.

Additional Reading

Coverage of Slavitt’s remarks also ran in California Healthline, Health Affairs, Healthcare Dive, and Politico.

Note: this article is intended to keep small business owners up on the latest news. It does not necessarily represent the policy stances of NFIB.

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