The Second Enrollment Period Under the ACA May Lead to More Unanswered Questions

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medical-billing-advocate_136007231If you are planning to sign up for health insurance on the HealthCare.gov site, you can find out how much rates have increased in November – but not until after the mid-term election. This is just one of many issues still plaguing the administration and their embattled HealthCare.gov insurance marketplace site.

In addition to the delayed start date and huge rate increases in some states, the enrollment period has been shortened significantly. Another concern is the secrecy surrounding the testing process with insurance companies who will be participating in the exchange.

The biggest question about enrollment on the Affordable Care Act’s health insurance exchanges – now in its second year of operation – is how much premiums will cost. Unfortunately, actual prices won’t be available until the exchanges open on November 15, leaving the American public to sort through the limited information available to make their own assumptions.

Opponents say the administration intentionally changed the enrollment date because of high rate hikes in key election states where the balance of power in the Senate could be determined. In the Louisiana, Iowa, and Alaska Senate races over the past week, double-digit rate hikes have become a hot point. Republican candidates are pummeling their Democratic opponents for the “huge” premium increases anticipated to affect many customers under the Affordable Care Act.

 “Clearly, President Obama does not want voters to see increased prices, more cancellations and decreased options under Obamacare before they go to the ballot box.”

“Clearly, President Obama does not want voters to see increased prices, more cancellations and decreased options under Obamacare before they go to the ballot box,” Republican Representative and Majority Leader, Eric Cantor, said in a statement.

 

The Hardest Hit

Alaska has some of the most significant increases, including double digit rate hikes for two insurers, Premera Blue Cross and Moda Health. According to Alaska Dispatch News, Premera’s premiums will rise by 35 to 40 percent, and Moda’s rates will increase between 22 and 28.8 percent.

medical-advocacy_160922333Many Alaskans, however, won’t feel the full effect of these rate increases, because the majority receives federal subsidies to cover a portion of their premiums. The Senate race in Alaska, which could be affected by the media firestorm related to the rate increases, pits Republican Dan Sullivan against incumbent Democratic Senator Mark Begich.

The Senate race in Iowa has also made Obamacare a flashpoint. Republican Senate candidate Joni Ernst has denounced the premium increase in her state, vowing to “repeal and replace Obamacare with patient-centered healthcare reforms that lower costs, increase choice, and actually improve care.” Her opponent – in a race that is too close to call – is Democratic Rep. Bruce Braley.

At issue, the approval last week by the Iowa insurance commissioner of a premium increase for two insurance carriers that are joining the exchange: CoOpportunity Health and Coventry Health. CoOpportunity will raise its rates by about 19 percent, and Coventry is increasing by about 9 percent.

medical-advocacy_171547334The Louisiana Senate race has also been affected by this issue, where Democratic Senator Mary Landrieu is lobbying for re-election against Republican Representative Bill Cassidy. Rep. Cassidy expressed great concern for his state, saying “premiums have gone up by 53 percent for the average Louisiana policyholder and many of these policies will again see double-digit increases,” he argued. “It’s unfair to Louisianans who have to balance their budgets and their businesses.”

The attacks by Republicans against Democrats and Obamacare lead the American public to believe that premiums are skyrocketing throughout the country. However, in most states, premiums for Obamacare for 2015 are increasing at a rate that is normal, considering inflation, and in line with other health insurance plans throughout the country.

The rates for insurers participating with HealthCare.gov are even going down in some states. In fact, according to PricewaterhouseCooper’s report October 3rd, the average premium increase this year across all reporting states is 5.9 percent, a fairly mild increase.

If the Obama Administration would release information about premium rates early, rather than waiting until after the election, the reality of minimal increases across the board would be clear to all. Instead, misinformation and secrecy abound, causing distrust and consternation for many who plan to use the site for enrollment.

 

Administration Fails to Learn from Last Year’s Mistakes

Many people can’t forget the catastrophic launch of HealthCare.gov last year, when the system was plagued with problems. After a litany of issues such as timeouts, errors and slow responses, a discouragingly small number of people signed up for private health insurance plans through the federal marketplace in October 2013.

medical-advocacy_171929318Users complained of slow performance and an extremely confusing site that required them to re-enter the same information in multiple forms and on multiple pages. Finally, federal officials were able to get the website working by enlisting a former Microsoft executive, and it was up and running well enough to enroll more than 8 million customers by early April, according to a statement made by President Obama.

In addition to a lack of forthright information about premiums this year, which may make it difficult for applicants to budget early, potential enrollees will also likely be frustrated with the shortened time available to enroll. Last year’s rollout enrollment period began on October 1st.

This year, the session for enrollment has been cut in half to only three months – November 15th through February 15th. This gives potential applicants limited time to budget, plan, and make decisions for the coming year, particularly for those who must make a decision by the end of the year.

Another disappointing development for many people is the administration’s decision to put a gag order on the insurance companies who are testing the website and the system. Rather than operating with transparency and frankness about potential problems, which would give them the opportunity to counteract last year’s open enrollment debacle, the administration continues to keep the entire process hush-hush.

According to an October 7th article in The Wall Street Journal, the Centers for Medicare and Medicaid Services sent an email to participating insurance companies stating they would require “all testers to acknowledge the confidentiality of this process to access the testing environment”. The email alert very clearly spells out the conditions that must be met, asking that insurance companies “… not use, disclose, describe, post to a public form, or in any way share Test Data with any person or entity, including but not limited to the media”.

Last year, during the inaugural enrollment period of HealthCare.gov, the administration did not require a confidentiality agreement from insurers. Consequently, information was leaked by insurance executives hinting at some problems in the system. It didn’t take long for everyone to realize just how bad those problems actually were. Given their past track record, it seems that transparency and owning up to any problems immediately would be the most beneficial approach.

 

Some Improvement

A rare bit of good news about the embattled site is that the updated version of the site (which was released in early October) contains a streamlined online application. Applicants struggled through 76 screens to complete the application process last year; it has now been reduced to just 16. But will this improvement be a big enough change to dispel the frustration from last year? Only time will tell.

Filed under: US Healthcare, Resources, Obamacare, Healthcare in Politics, Affordable Care Act

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