Administration Tightens Documentation Standards for ACA Special Enrollment Periods

Washington, D.C. – Consumers who use the most common Special Enrollment Periods (SEPs) to purchase health insurance in the state and federal marketplaces will now have to provide additional documentation as part of the application process, according to an announcement today by the Department of Health and Human Services. SEPs are allowed for life-changing events that fall outside the open enrollment period of November through January. The most common among these are a birth, marriage, adoption, a move, or loss of insurance because of changing jobs or the loss of a job. “Under the new process, all consumers applying through the most common special enrollment periods will need to submit documentation to verify their eligibly to use an SEP,” according to the announcement. Following is the statement of Rachel Klein, director of organizational strategy for Families USA.

“We should be making it easier for people to sign up for health insurance, not harder. If there is a problem with special enrollment periods, let’s design solutions that don’t add a lot of red tape that keeps eligible consumers from getting the coverage they need.

“Most consumers are still learning about how the new health insurance marketplaces work, how to navigate a complex enrollment process, and when to apply. In fact, data show that fewer than 15 percent of those eligible for SEPs have used them. The Administration should focus on raising consumer awareness about these opportunities instead of putting bureaucratic roadblocks in the path of people trying to protect their health and that of their families.