For a year, consumers will be on the honor system for subsidies under the Patient Protection and Affordable Care Act.
That’s what the Obama administration quietly announced Friday, days after unexpectedly announcing they would delay the employer mandate penalty for another year.
In a new 606-page rule published Friday, the administration said they would significantly scale back on the law’s requirements that the new exchanges verify consumers’ income and health insurance status until 2015, when stronger verification systems are in place.
In the meantime, the government will rely on consumers’ self-reported information.
Health insurance exchanges set up under PPACA are set to begin open enrollment Oct. 1. Enrollees with incomes ranging from 100 percent to 400 percent of the federal poverty line are eligible to receive tax subsidies to help them buy insurance. They also must not have access to insurance through their employer to qualify.
“The exchange may accept the applicant’s attestation regarding enrollment in eligible employer-sponsored plan . . . without further verification,” according to the final rule.
The administration has said they would conduct random checks to verify whether new applicants receive employer-sponsored insurance benefits, while also verifying income status.
But the new regulations from the Department of Health and Human Services said the 17 state-based exchanges would have until 2015 to do random checks, citing “legislative and operational barriers.”
In all 50 states, though, the federal government will scale back oversight of what applicants say they earn.
That move, some critics say, could lead some consumers to overreport their income in order to qualify for federal tax subsidies, at least in states that are not expanding Medicaid coverage.