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Checks for federal health aid get easier

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By The Washington Post
Saturday, July 6, 2013, 7:54 p.m.
 

The Obama administration announced on Friday that it would significantly scale back the health law's requirements that new insurance marketplaces verify consumers' income and health insurance status.

Instead, the federal government will rely more heavily on consumers' self-reported information until 2015, when it plans to put stronger verification systems in place.

The delay falls on the heels of a Tuesday announcement that the federal government would postpone for one year a requirement that employers with 50 or more full-time workers provide health coverage.

“I think that Health and Human Services is doing the best that it can under the circumstances,” said Sara Rosenbaum, a health policy professor at George Washington University.

The verification systems are meant to determine who qualifies for benefits under the Affordable Care Act. The law includes tax subsidies to buy health insurance for Americans who earn less than 400 percent of the poverty line, about $45,000 for an individual.

Those earning less than 133 percent of the poverty line — about $15,000 — will qualify for Medicaid coverage in Washington, and 23 states that have decided to expand the program.

The federal government needs to know who receives health insurance coverage from an employer. Consumers who receive affordable health insurance from their company under a policy that costs less than 9.5 percent of their income do not qualify for tax credits under the Affordable Care Act.

Regulations published Friday scaled back the federal government's role in determining whether information submitted to new health marketplace is accurate.

After encountering “legislative and operational barriers,” the federal government will not require Washington and the 16 states that are running their own marketplaces to verify a consumer's statement that they do not receive health insurance from their employer.

“The exchange may accept the applicant's attestation regarding enrollment in eligible employer-sponsored plan ... without further verification,” according to the final rule.

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