Proposed Rules to Implement Health Reform Will Streamline Access to Coverage

The Department of Health and Human Services and the Treasury Department last week issued three proposed rules that are central to ensuring that the Affordable Care Act (ACA) greatly reduces the number of uninsured Americans.  The rules will help states modernize their systems for enrolling people in health coverage to replace the outdated systems that most states use in their Medicaid programs.

Under the proposed rules, consumers will be able to use a single, streamlined application for Medicaid, the Children’s Health Insurance Program (CHIP), and the new tax credit to help people buy private coverage through a state insurance exchange.  The state will then determine which (if any) of these forms of assistance the applicant qualifies for.

The rules also allow states to use data they already have, such as from tax returns or other programs like the Supplemental Nutrition Assistance Program (formerly called food stamps), to verify applicants’ incomes, eliminating the need for consumers to send in paper proof such as pay stubs.

People will be able to apply for coverage online, in person, and by phone, and many of them should get a decision on their application the same day.

States still have a great deal of work to do to implement these changes before the fall of 2013, when people will first be able to enroll for coverage.  But overall, these proposed regulations would make a number of important improvements to the eligibility and enrollment process that will be critical to achieving the coverage goals of health reform.