In case there was any shred of doubt left that they’re deeply worried about Healthcare.gov breaking down under the crush of traffic next month, this ought to take care of it. First they moved the deadline for enrollment back, now they’re lining up insurance companies to start handling enrollments directly as December 23rd approaches.
Another one of those options is allowing insurers to sign up consumers from start to finish —called, “direct enrollment.” If consumers choose to directly enroll in a Marketplace plan through an insurance company, they still will be able to compare products, and choose the one that offers them the best value for their dollar. Consumers will be informed that they can compare and select other plans on HealthCare.gov, and prior to buying a health plan, consumer’s application will be securely routed to HealthCare.gov to assess their eligibly for coverage along with potential discounts on premiums and cost sharing. Consumers must have their eligibility verified through the Data Services Hub – regardless of which path they use to enroll.
The option of direct enrollment has been there from the start, and although some issuers have already begun using this option, it has been limited by recent problems with the website. However, we recently announced that we have put in place fixes for more than two-thirds of the high priority bugs related to the website. For this reason, today, we are announcing that issuers in Florida, Texas, and Ohio are ready to participate in a pilot program using this direct enrollment feature, which will help inform our efforts to make this option work better for issuers and consumers in the coming weeks. Under the new pilot program being launched today, issuers utilizing direct enrollment in these three states will provide detailed feedback on their experiences to feed into our real-time work to make improvements for both consumers and issuers. This will help make direct enrollment a viable option for all issuers that wish to use this feature.
Insurers have been pressing them to do this for weeks. The big problem to date was that there were too many privacy concerns involved in giving insurance companies access to federal data hubs about Americans in the name of verifying eligibility. Sounds like they’ve solved that problem somehow — or maybe they just think they’ve solved it. Despite tech experts testifying before Congress that Healthcare.gov presents “critical” security risks, newly-legendary tech moron Kathleen Sebelius says she’s confident it’s fine. Could be they’re rolling this out as a pilot program precisely because they don’t know how secure it’ll be in practice. Good luck, America.
But never mind all that. Isn’t there a bigger problem? Here’s how the Times described the logistical challenges in its story about direct enrollment 10 days ago:
The main stumbling block for some consumers is the need to determine their eligibility for subsidies, and the amount. Insurance companies can now only estimate the amount for them. It is up the government to verify eligibility, using personal financial information from tax returns and the like.
“The question is, can they create a separate direct pathway so consumers can get that information on their subsidies?” asked one industry official. “If they don’t have Healthcare.gov up and running by the end of the month, direct enrollment is critical.”
Actually, insurance companies don’t need to estimate the subsidies an applicant is eligible for because … you can’t get subsidies if you don’t enroll through an exchange. Remember? Read this post to refresh your memory. Sebelius herself is sufficiently worried about people being unwittingly disqualified from subsidies by enrolling directly with insurers that she took care to say a few days ago that only people who know they earn too much income each year to qualify for help from Uncle Sam should consider going that route. And yet, the issue isn’t mentioned in today’s HHS press release. Could be, I guess, that the reference to “potential discounts on premiums and cost sharing” is a veiled reference to subsidies. If so, is HHS suggesting that … they will allow people to apply for subsidies even if they enroll outside an exchange? That would be the third highly illegal move Obama’s made in the name of doing triage on this policy car crash. First was delaying the employer mandate, second was his declaration that insurers can go ahead and un-cancel plans if they like, and now this. Maybe the press release is simply written ambiguously, and what they really have in mind is insurers gently informing lower-income people who qualify for subsidies that they’ll just have to be patient and wait until the website’s working. But either way, I want to know. Either they’re breaking the law or they’re encouraging a de facto two-tiered enrollment system for the lower and middle classes, respectively.
Exit question: Chin up, Democrats. What could go wrong?
I was at yesterday's off-the-record session with #PresidentObama. Can't report it, but can say: he's all in on ACA.
— Howard Fineman (@howardfineman) November 22, 2013