New health insurance regulations introduce changes to Affordable Care Act

health insurance exchanges
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Obama administration introduces more health insurance revisions

As the Affordable Care Act inches closer to becoming fully enacted in the U.S., the Obama administration is making somewhat unexpected moves on the health care law and its provisions concerning health insurance. The federal law is set to go active in its entirety on January 1, 2014. Once the law has been fully enacted, it will be too late for states throughout the country to comply with its provisions, which is somewhat problematic due to the fact that most states have yet to make any attempt to make headway on these provisions. This problem has not been ignored by the Obama administration, which has expressed concerns for the future of health insurance if aggressive action is not taken.

New regulations change the provisions governing health insurance exchanges

On the heels of a recent announcement concerning the delay of a health insurance provision concerning large businesses, the Obama administration has announced that it will be relaxing some of the requirements that have been imposed on states in regards to health insurance exchanges. These exchanges are meant to be online marketplaces where consumers can find affordable coverage and federal law requires that all states have a working exchange in place by January 1, 2014. Those enrolling in these exchanges could receive subsidies from the federal government that will offset the cost of health insurance coverage, but the Affordable Care Act has many stipulations concerning these subsidies.

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health insurance exchangesHHS relaxes standards for income investigations

According to federal law, those with incomes ranging from 100% to 400% of the federal poverty level are eligible to receive subsidies for health insurance from exchanges. These exchanges are required to verify whether these consumers receive employer-sponsored insurance through a series of spontaneous inspections. If these people do receive such benefits, they are no longer considered eligible for subsidies. The problem, however, is that many states have not taken steps to establish a system that would be able to do this efficiently or without adding inordinate costs to the exchange systems themselves. For states operating their own health insurance exchanges, this requirement will not become an issue until 2015 due to new regulations from the Department of Health and Human Services.

New regulations limit investigations for 2014

According to these new regulations, state’s operating their own health insurance exchanges can accept a consumer’s attestation of their not receiving coverage from their employers without instituting an investigation. Exchanges will only be requires to perform random investigations into a consumer’s income in 2014, and these investigations are not requires to be comprehensive in any way. In 2015, however, exchanges will need to increase their inspections to ensure that consumers comply with federal guidelines concerning subsidies and the health insurance coverage they receive through exchanges.

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