The subgroup, which is part of the National Association of Insurance Commissioners (NAIC), talk about coverage for non-citizen children in a set of Frequently Asked Questions (FAQs) about Healthcare Reform.
The subgroup is in the process of updating the draft.
State insurance departments can use the FAQ set to answer questions about the Patient Protection and Affordable Care Act of 2010 (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA).
In an answer to question 121, they note that consumers cannot buy coverage for children who are not lawfully present through a PPACA exchange, but that they can buy coverage for a non-lawfully-present child either directly through an insurance company or through an agent.
Insurers that sell coverage through a PPACA exchange must make the policies available outside the exchange coverage to parents of children who are not eligible to participate in the exchange, officials say.
In an addition to the FAQ set, and in response to a question about consumers who find themselves enrolled in Medicaid or Children’s Health Insurance Plan (CHIP) coverage while also getting advance premium tax credit (APTC) subsidies through a PPACA exchange, officials say those consumers should contact the exchange to eliminate the duplicate coverage.
“They will likely have to pay back all or some of the text credits received,” officials say.
Consumers who have APTC subsidies, apply for Medicaid or CHIP coverage, and then are rejected for Medicaid or CHIP coverage need not necessarily take further action, but they should contact Medicaid or CHIP managers to verify that they are not enrolled in Medicaid or CHIP coverage, officials say.