In response to President Trump’s October 12 executive order (EO), the U.S. Departments of Health and Human Services (HHS), Labor (DOL) and Treasury have published proposed rules to expand the availability of health coverage sold through short-term, limited duration insurance (STDLI). The public has until April 23, 2018 to submit comments on these proposed rules; the new standards are slated to be effective 60 days after publication of the final rules.
Federal Requirements and State Flexibilities for Verifying Eligibility Criteria
Manatt Health Solutions – Deborah Bachrach and Kinda Serafi
The Affordable Care Act and the final Medicaid and Exchange regulations issued in March 2012 contemplate: real-time eligibility determinations; coordinated information technology eligibility systems across Insurance Affordability Programs; and, a simplified enrollment pathway for applicants that relies on electronic database verification coupled with self-attestation. States have a great deal of flexibility when establishing the income verification process for Medicaid/CHIP and the advance premium tax credits (APTC)/cost sharing reductions. This brief prepared by Manatt Health Solutions summarizes some of the key verification requirements, with an emphasis on financial eligibility. The chart in the brief summarizes federal requirements and areas for potential state flexibility when verifying eligibility for both Medicaid and APTCs.