By Mara Lee | June
26, 2017
The Senate revised its Affordable Care Act replacement on Monday
in an effort to replicate the effects of the individual mandate.
Starting in 2019, people who try to buy a healthcare insurance policy during open enrollment, or because of a life-qualifying event, will not be able to do so for six months if they had a break in coverage of 63 days or longer during the prior year.
The tweak to Better Care Reconciliation Act comes just hours before the Congressional Budget Office is set to release its score of the Senate GOP bill.
Under the Affordable Care Act, consumers could not sign up for health coverage during a special enrollment period just because they had fallen ill. They had to lose coverage because of job loss, a spouse's job loss or a divorce in order to qualify.
The six month waiting period would begin from the day of application, if the customer applied during open enrollment or if the customer qualified for special enrollment.
But if the person applied outside of open enrollment and did not have a qualifying event, the waiting period would be either six months or the first day of the following plan year, whichever is later.
This rule is intended to prevent the problem of the only people buying insurance being those who know they need coverage for a current illness. When that happens, premiums rise higher than they would if everyone was buying a policy, and those increases tend to drive out more customers, especially those without substantial subsidies.
Starting in 2019, people who try to buy a healthcare insurance policy during open enrollment, or because of a life-qualifying event, will not be able to do so for six months if they had a break in coverage of 63 days or longer during the prior year.
The tweak to Better Care Reconciliation Act comes just hours before the Congressional Budget Office is set to release its score of the Senate GOP bill.
Under the Affordable Care Act, consumers could not sign up for health coverage during a special enrollment period just because they had fallen ill. They had to lose coverage because of job loss, a spouse's job loss or a divorce in order to qualify.
The six month waiting period would begin from the day of application, if the customer applied during open enrollment or if the customer qualified for special enrollment.
But if the person applied outside of open enrollment and did not have a qualifying event, the waiting period would be either six months or the first day of the following plan year, whichever is later.
This rule is intended to prevent the problem of the only people buying insurance being those who know they need coverage for a current illness. When that happens, premiums rise higher than they would if everyone was buying a policy, and those increases tend to drive out more customers, especially those without substantial subsidies.
Mara Lee covers developments in health care
policy in Congress and around Washington. This is her second time covering the
Hill. In a previous life, she covered Midwestern delegations for Scripps and
Gannett newspapers in Indiana and Michigan. Over her 20-year-plus-career, she’s
spent more time outside the Beltway, both as a business reporter for The
Hartford Courant and nine years in Ohio, mostly at the Dayton Daily News. She
won an award for coverage of Oxycontin addiction Ohio in 2003, as well as for Census,
business and breaking news coverage in Ohio and Connecticut. She’s a Virginia
native, and graduated from the University of North Carolina-Chapel Hill.
Twitter handle: MaraRhymesSarah
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