Topics: Obamacare

Obamacare spokeswoman says most people are 'truthful' when seeking government benefits

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Beltway Confidential,Opinion,Philip Klein,Obamacare,Health Care,Medicare and Medicaid,CMS,Health Care Exchanges

Dismissing questions about the potential for individuals to exploit the latest Obamacare enrollment loophole, a spokeswoman for President Obama's health care law Wednesday insisted that relying on an honor system was okay because most people are “truthful” when seeking government benefits.

After asserting as recently as two weeks ago that the March 31 deadline for individuals to signup for coverage through Obamacare was firm and there was “no statutory authority” for the administration to extend it, Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, defended a new policy that would effectively do so indefinitely.

Fielding questions from reporters on a conference call, Bataille said the new policy, officially announced Wednesday, would technically keep the March 31 deadline intact. But effectively, it would still allow individuals to enroll after that point if they offered an “attestation” that they tried to sign up before that date but couldn’t complete the process.

“Just like Election Day, if you are in line when the polls close, you get to vote,” she said. “We won’t close the door on people who tried to get covered but were unable to do so through no fault of their own.”

Bataille ducked several questions from reporters asking whether there was any verification process in place to certify that individuals applying after March 31 really did start to apply before the deadline. She also refused to say whether there were any consequences for individuals caught lying.

“The reality is that consumers have to attest that they were eligible for this coverage,” she said. “And I think it’s also important to recognize that this is an official federal application for marketplace coverage, and most people are truthful when applying for those benefits.”

In 2011, according to a report by the Government Accountability Office, the federal government made an estimated $115.3 billion in improper payments, of which more than half came from Medicare and Medicaid -- the programs run by Bataille's agency, CMS.

In addition, Bataille wouldn’t offer a firm date after which people could no longer claim they began an application before the deadline.

“It’s difficult for us to specify how long of a line we might have, so what we’re doing is making sure that we’re prepared to be flexible to accommodate those consumers who may have come into the system,” she said. “It could take a few days, it could take a week or so in order to make sure that those consumers who come in are able to complete their coverage.”

This makes insurers nervous, because they see a limited open enrollment period as crucial to ensuring a balanced pool of applicants. If people can sign up for insurance whenever they want, then younger and healthier people might just wait until they get sick or injured to seek coverage. Furthermore, insurers need to get a sense of what the final risk pool of the exchanges looks like so that they can calculate rates for 2015, which are due in the coming months. If the ultimate deadline to enroll remains vague, that becomes much more difficult.

Robert Zirkelbach, a spokesman for insurance industry lobbying group American Health Insurance Plans, wrote in an email: “It is important to ensure that people who have tried to sign up are able to get coverage, and health plans will continue to do everything they can to help consumers through the enrollment process. The new special open enrollment period needs to be limited to a defined period of time with a clear end date. This provides an incentive for people to enroll. It is also necessary so that health plans know who is covered as they develop and submit premiums for next year, which is required in some states as early as April.”

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