ACA 760K Cuts: Trump Administration Restores Some Plans
The ACA 760K cuts announced late last month are being partially undone, with the Centers for Medicare & Medicaid Services quietly reinstating some of the people removed from Affordable Care Act plans, KFF Health News reported Thursday.
Late in September, the Trump administration announced it had cut 760,000 people from the ACA rolls, saying the move targeted fraud and improper enrollments and touting billions in potential taxpayer savings. But not all of those kicked off were fraudulently enrolled, insurance industry sources told KFF Health News — CMS has restored a small number of people whose coverage should never have been canceled, and more could follow as enrollees discover they are uninsured only when they try to use their coverage.
Insurers Confirm Reinstatements
David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association, confirmed that some of the association’s members are among those who have been put back on their plans. He said CMS has set up an expedited review process for people who discover they were improperly disenrolled.
The reinstatements raise fresh questions about how the sweeping anti-fraud effort was carried out — and whether legitimate consumers were swept up because they failed to open a letter from their insurer or answer a phone call.
Phase Two: 419,000 More Under Review
The questions are swirling even as a second phase of the effort is already underway. An additional 419,000 sign-ups are being scrutinized, and insurers must tell CMS how many of those enrollees do not respond to outreach efforts by around mid-to-late November — after the midterm elections, Merritt said.
How the Sweep Worked
The process began in June, when the agency selected nearly 1.2 million enrollments it said showed four warning signs. Insurers were told to review the files, contact people by at least two methods — such as a phone call and a letter — and give policyholders 30 days to respond and supply missing information. Those who did not respond were disenrolled.
Supporters of the sweep, including Brian Blase of the Paragon Health Institute, say the crackdown was long overdue. Other policy experts question how many legitimate consumers were caught in the dragnet. Katie Keith of Georgetown Law said some enrollments may not have been authorized, while other people may simply have been lost in the process despite holding valid coverage — and that without more information it is almost impossible to tell the difference. The anti-fraud moves affect people in states that use Healthcare.gov to buy ACA coverage.
Source: KFF Health News