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Trump Administration Reinstates Some ACA Enrollees After Cutting 760K

11:08 PM ETConfirmed

World Desk

In Short: The Trump administration also announced the removal of subsidies for about 189,000 ACA enrollees with duplicate Medicare, Medicaid, or CHIP coverage, citing a failure to look for concurrent enrollments or continued coverage for dead people.

Late last month, the Trump administration announced it had cut 760,000 people from the ACA rolls, citing fraud and improper enrollments, and touting billions in potential taxpayer savings.

According to information provided to KFF Health News, CMS in June selected nearly 1.2 million enrollments for further review, based on four warning signs for fraud. CMS then sent lists of these ACA accounts to specific insurers, instructing them to use at least two methods of contact to reach the enrollees.

Johnny Wallin, chief operating officer of Texas-based Marketplace Insurance Exchange, said insurers reached out to his organization for help contacting people on the CMS lists, prompting an 'all-hands-on-deck' effort by agents to reach clients, some of whom were vacationing overseas.

CMS Administrator Mehmet Oz and Brian Blase, whose Paragon Health Institute has supplied many of the findings cited by those alleging widespread enrollment fraud in the ACA, defended the move as long overdue.

Insurers must inform CMS by mid-to-late November of how many of those enrollees do not respond to outreach efforts, said David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association.

The Trump administration also announced the removal of subsidies for about 189,000 ACA enrollees with duplicate Medicare, Medicaid, or CHIP coverage, citing a failure to look for concurrent enrollments or continued coverage for dead people.

Still, the administration is now reviewing an additional 419,000 sign-ups, indicating that the process is ongoing and complex.

The Trump administration's decision to cut 760,000 people from ACA rolls while reviewing an additional 419,000 sign-ups highlights the ongoing challenges in balancing fraud prevention with access to healthcare.

Background

What's confirmed

• Late last month, the Trump administration announced it had cut 760,000 people from the ACA rolls, citing fraud and improper enrollments, and touting billions in potential taxpayer savings.
• According to information provided to KFF Health News, CMS in June selected nearly 1.2 million enrollments for further review, based on four warning signs for fraud. CMS then sent lists of these ACA accounts to specific insurers, instructing them to use at least two methods of contact to reach the enrollees.
• Johnny Wallin, chief operating officer of Texas-based Marketplace Insurance Exchange, said insurers reached out to his organization for help contacting people on the CMS lists, prompting an 'all-hands-on-deck' effort by agents to reach clients, some of whom were vacationing overseas.
• CMS Administrator Mehmet Oz and Brian Blase, whose Paragon Health Institute has supplied many of the findings cited by those alleging widespread enrollment fraud in the ACA, defended the move as long overdue.
• Insurers must inform CMS by mid-to-late November of how many of those enrollees do not respond to outreach efforts, said David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association.
• The Trump administration also announced the removal of subsidies for about 189,000 ACA enrollees with duplicate Medicare, Medicaid, or CHIP coverage, citing a failure to look for concurrent enrollments or continued coverage for dead people.
• Still, the administration is now reviewing an additional 419,000 sign-ups, indicating that the process is ongoing and complex.
• The Trump administration's decision to cut 760,000 people from ACA rolls while reviewing an additional 419,000 sign-ups highlights the ongoing challenges in balancing fraud prevention with access to healthcare.

What's still developing

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• Tons of points, explosive plays left and right, and LOTS of interesting waiver wire adds.

Sources

• NPRlink
• Washingtonsunlink
• Smoothradiolink
• 13Wmazlink
• Bolaviplink
• AP Newslink
• Clickorlandolink
• Newslink
• Fantasylifelink
• Whdhlink
• Timesofisraellink
• Eonlinelink
• Calslink
• WarpBeat — background on Trump Administration Sues California Over Voter Rolls link
• WarpBeat — background on Trump administration again asks for emergency relief link