WASHINGTON (AP) — The Trump administration took steps Wednesday intended to help calm jittery insurance companies and make tax compliance with former President Barack Obama's health law less burdensome for some people.
The moves announced separately by the Health and Human Services Department and the IRS don't amount to sweeping changes to the Affordable Care Act. That would fall to Congress, where Republicans are struggling to reach consensus over how to deliver on their promise to repeal and replace the health law.
But the administration's actions do signal a change in direction.
For consumers, the proposed HHS rules mean tighter scrutiny of anyone trying to sign up for coverage outside of open enrollment by claiming a "special enrollment period" due to a change in life circumstances such as the birth of a child, marriage, or the loss of job-based insurance. Also, sign-up season will be 45 days, down from the current three months.
For insurers, the curbs on special enrollment periods are a big item. The industry claimed that some consumers were abusing special enrollment by signing up when they needed expensive treatments, only to drop out later.
Insurers also would gain more flexibility to design low-cost coverage tailored to younger people. In another move aimed at consumers who move in and out of coverage, insurers would be able to collect back premiums from customers who had stopped paying, then tried to sign up again for another year.
Separately, the IRS is backing off from a tighter approach to enforcement that was in the works for this tax-filing season.
Under the law, people are required to have health coverage or risk fines from the IRS — a penalty usually deducted from a taxpayer's refund. That underlying requirement remains on the books, and taxpayers are still legally obligated to comply, the IRS said.
But the agency is changing its approach to enforcement. Originally, the IRS had planned to start rejecting returns this year if a taxpayer failed to indicate whether he or she had coverage. Now the IRS says it will keep processing such returns, as it has in the past.
Many of the law's supporters consider the coverage requirement essential for nudging younger, healthy people into the insurance pool to keep premiums in check.
Hours after his inauguration President Donald Trump signed an executive order directing federal agencies to look for ways to ease requirements of the 2010 health care law.
The IRS said in a statement that it is following through, but "taxpayers remain required to follow the law and pay what they may owe?."
Administration officials said the HHS rules will help to stabilize the individual health insurance market for next year. That could buy time for congressional deliberations on the ultimate fate of the health care law. Trump's health secretary, former Rep. Tom Price, R-Ga., was confirmed only Friday.
The industry group America's Health Insurance Plans commended the administration, but said in a statement more is needed. In particular, insurers want Trump and Congress to remove a legal cloud over billions of dollars in subsidies that they are obligated to pay to cover deductibles and copayments for low-income people.
It remained unclear if insurers would be swayed. Only Tuesday, Humana announced Tuesday it will not participate in next year in the government-run marketplaces, where insurer exits have already diminished consumer choice.
Supporters of the health care law reacted sharply to the administration proposal, saying it would raise costs for consumers and take away choices.