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New ACA Rule Puts Exchange Customers On The Honor System

07/08/13

  11:25:03 am, by MedBen5   , 173 words,  
Categories: News, Health Plan Management

New ACA Rule Puts Exchange Customers On The Honor System

While the health care community was still abuzz about the announcement that the federal government would postpone the employer mandate until 2015, the Obama administration quietly communicated on Friday that it would also reduce the onus on state exchanges to verify consumers’ income and health insurance status.

The Washington Post reports that in 2014, the insurance marketplaces could rely more heavily on consumers’ self-reported information, in the hopes that stronger verification systems would be in place the following year.

Under the Affordable Care Act, Americans who earn less than 400% of the proverty line – roughly $45,000 for an individual – can use tax subsidies to offset the cost of buying health insurance, provided they don’t already receive affordable health insurance from their company. The new regulations put prospective exchange customers on the honor system in regard to meeting this criteria.

“The exchange may accept the applicant’s attestation regarding enrollment in eligible employer-sponsored plan… without further verification,” according to the final rule, which also scaled back states’ responsibilities to double-check the income levels that consumers report.

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