Officials to test tightening ObamaCare sign-up rules

The Obama administration said Tuesday that it is planning to test out further steps to tighten the rules for ObamaCare sign-up periods that have drawn insurer complaints. 


The Centers for Medicare and Medicaid Services (CMS) said that it will launch a pilot program in 2017 to test ways to put in place a “pre-enrollment verification system,” meaning a way to check documentation to make sure enrollees are actually eligible to sign up for ObamaCare through an extra sign-up period. 

The extra sign-up periods, known as Special Enrollment Periods (SEPs), allow people to sign up for coverage if they meet certain criteria, for example if they just moved residences. 

But insurers have long complained that people were gaming the system to use these periods to sign up only after they got sick, driving up costs. 

The Obama administration has been taking a series of steps to address some insurer complaints as high-profile exits of ObamaCare marketplaces by large insurers have raised questions about the sustainability of the health law. 

Increasing the checks on documentation to ensure eligibility before people can sign up would be a move towards further addressing insurer objections. 

Some consumer groups, though, have warned that the administration should not make it overly burdensome for people to enroll. 

"I'm pleased that this is going to be just a pilot, but anything really that could depress enrollment is concerning to us," said Liz Hagan, senior policy analyst at Families USA, a liberal healthcare advocacy group. 

CMS said Tuesday that steps it has already taken have reduced the number of SEP sign-ups by 15 percent so far this year.

This story was updated at 3:26 p.m.