Open-enrollment season will be the biggest on record
At the Silver State Health Insurance Exchange in Carson City, NV, workers have been counting down the days until Oct. 1 on an office corkboard, according to a report in Kaiser Health News.1 Now it is only days to the deadline for opening the online marketplaces that are a linchpin of the federal health law known as Obamacare, the report said.
"We certainly will need every one of the days that we have left," said Jon Hager, executive director of the Nevada exchange. "But I am confident we will be ready to go."
Nevada is one of 15 states racing to launch their own marketplaces where consumers can compare plans’ prices and benefits, and find out if they are eligible for a federal subsidy or Medicaid. Those marketplaces, also called exchanges, are key to expanding insurance coverage to an estimated 25 million Americans over the next decade. The other states are relying on the federal government.
The coming days "are the sprint to the biggest open-enrollment season we’ve ever seen in this country," said Ceci Connolly, managing director of PricewaterhouseCoopers’ Health Research Institute, told Kaiser Health News. "We know that this will be a real crunch period."
Opening the marketplaces on time represents the Obama administration’s biggest opportunity to fulfill the law’s promise to extend coverage to uninsured Americans, including those who have been denied coverage in the past because of health conditions. Since the Supreme Court upheld the law in June 2012, though, officials have had to overcome many hurdles, from states’ reluctance to participate, to critics’ predictions of unaffordable coverage, to unexpectedly tight money.
A quirk in the law gave generous funding for consumer outreach in states with their own marketplaces, but little for states with a federal exchange. That quirk could be a problem since polls show that most Americans know little about how the law affects them.
There are also technical challenges: Obamacare supporters like to compare shopping on the exchanges to buying an airplane ticket on Travelocity or Expedia, but building the back-end system is far more complicated, requiring computers at state and federal agencies to be able to talk to one another in real time to verify an individual’s income and citizenship status, and determine eligibility for federal subsidies or Medicaid. That system also needs to connect with the computers run by insurance companies.
The biggest questions, though, revolve around who will show up and whether they will be able to afford coverage that takes effect Jan. 1 — especially the young and healthy, who will need to buy insurance in significant numbers to balance the costs of insuring the sick, who can no longer be turned away. The law requires most Americans to carry insurance in 2014, but some fear that the first-year penalties of $95, or 1% of income, won’t be a strong enough inducement. If mostly older, sicker people show up, insurers will pass on their healthcare costs in higher premiums that will make coverage for all individuals less affordable over time.
Political backdrop
All of these challenges are occurring in a politically charged environment in which both parties are already spinning developments to buttress their positions on the law. While the law’s effectiveness won’t truly be known for several years, underwhelming enrollment and high premiums could turn public opinion against Democrats before next year’s elections.
President Obama insists the exchanges will open on time and coverage will be affordable, although he acknowledges there will be bumps along the way, as there would be for any new program. The administration relaunched healthcare.gov, the web portal for the federally run exchanges, and opened a 24-hour-a-day call center to help consumers prepare for open enrollment by calling a toll-free number at (800) 318-2596.
Short on money and worried about starting outreach during the summer vacation period, the administration won’t launch its major public campaign until at least mid-September. But at press time, supporters of the law, such as the nonprofit Enroll America, were planning to start their own efforts.
Several states running their own exchanges, including Connecticut, Colorado, and Kentucky, have begun airing television commercials about the new options that will be available Oct. 1, for coverage that begins in January. Open enrollment runs through March.
Carrie Banahan, executive director of the Kentucky exchange that recently rebranded itself as Kynect — Kentucky’s Healthcare Connection, said, "People need to know this is coming so they can start thinking about it. Insurance is complicated, and we wanted to try to make it easily understandable as possible."
Reference
Galewitz P and Hancock J. Officials Prepare For Biggest Open-Enrollment Season We’ve Ever Seen.’ Kaiser Health News. June 23, 2013. Accessed at http://bit.ly/14idasg.
