The Department of Health and Human Services (HHS) on Friday, July 5, quietly published new regulations on income and employment verification for subsidized health care from the Health Insurance Marketplaces set to launch Oct. 1 in 16 states, along with a federal option for the other states.
This follows the July 2 announcement that the Affordable Care Act (ACA) employer mandate of "play or pay" regarding health insurance coverage for employees was being delayed from Jan. 1, 2014, to Jan. 1, 2015.
For 2014, there will be no employer verification checks on health insurance and only "random" individual, or family, income verifications by the state marketplaces. Thus anyone claiming to make between 100 and 400 percent of the Federal Poverty Level (FPL) and not being offered health insurance at work can obtain government-subsidized health insurance in 2014 with scant income verification and basically no chance at the state level of employer insurance verification.
The regulations, contained in a 606-page HHS rule, allow state-run exchanges to accept an enrollee's "attestation regarding enrollment in an eligible employer-sponsored plan."
The federal marketplace, covering the other 34 states, will still make random insurance verification checks in 2014.
"For income verification, for the first year of operations, we are providing [state and federal] exchanges with temporarily expanded discretion to accept an attestation of projected annual household income without further verification," the rule states.
Beginning in 2015, the state marketplaces may engage in "random" income verificaiton procedures.
The rules reflect the difficulty the marketplaces face in processing what could be an onslaught of applications for subsidized and other health insurance policies.