The federal health insurance exchange allows people to enroll for insurance coverage outside of the annual open enrollment period under certain circumstances, such as losing coverage from an employer. Insurers are concerned that some people are misusing this flexibility by reenrolling after their coverage was terminated for nonpayment of premiums. Not only is this against the rules, but it undermines the stability of the exchange. CMS doesn’t collect complete data that would allow it to gauge the extent of the problem. GAO recommends gathering data on coverage terminations for nonpayment of premiums.

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The White House on Friday cleared the CMS to scale back efforts to evaluate Indiana’s conservative approach to Medicaid expansion. The move could prevent the agency from gathering adequate data to determine if the state’s method of expansion harmed access to care.

Some feel that even with a scaled-back study, the CMS could still glean pertinent information from Indiana about the impact its expansion approach has had on Medicaid beneficiaries.

“Surveys were just one element, and getting rid of them is not enough to make or break an evaluation” said Doug Badger, a senior fellow at the Galen Institute, a conservative think tank.

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CBO is anticipating a 21% jump in the cost of federal subsidies this year, driven by a 34% jump in premiums for the “benchmark” plans to which those subsidies are pegged.

But after that, CBO expects a big slowdown. Federal spending on the ACA’s premium subsidies will likely grow by about 5% per year for the rest of the next decade, the budget office said. Those annual increases are mainly a result of rising health care costs.

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