Access to Employer-Sponsored Insurance and Subsidy Eligibility in Health Benefits Exchanges: Two Data-Based Approaches

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Consumers offered employer-sponsored insurance (ESI) can be ineligible for subsidies in health insurance exchanges (HIX), and until better ESI data become available, HHS proposes using post-enrollment audits, rather than pre-enrollment verification for this eligibility requirement. This paper examines two strategies through which exchanges can implement this policy by focusing audits on the consumers who are most likely to be ineligible.

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Date: Jan 2013
Author: Matthem Buettgens, Stan Dorn, and Habib Moody