The December 23rd enrollment deadline? Time to move that to next month. The deadline to pay your first month of premiums? Let’s go ahead and move that back too. Emergency treatment needed from an out-of-network provider? It’d be swell if that was covered the same way in-network treatments are. And what if your coverage is temporarily screwed up in January when you desperately need your prescriptions refilled? HHS “strongly encourages” insurers to pick up the slack.
In other words, they’re finally realizing that lots of people who had planned to have coverage next month won’t have it, whether because of their own procrastination, HHS’s technological incompetence, or the mind-boggling logistical problems that have been forced on insurers by Obama’s screw-ups and ass-covering political “fixes.” So now they’re going to pile another bunch of “fixes” on them — mere suggestions, wink-wink — and hope for the best, and if chaos ensues anyway in January, it’ll be insurers who are scapegoated.
Phil Klein’s right: It’s panic time in the White House. Let’s let this be the end of the “things are working better now” propaganda.
Among the guidance the HHS announced:
— It is requiring insurers to accept payments until Dec. 31 for coverage starting on Jan. 1. It is also “urging” insurers to give individuals more time beyond that to pay for coverage. In other words, if somebody pays for coverage in the middle of January, HHS is asking insurers to retroactively make that person’s coverage effective as of Jan. 1. HHS is also asking insurers to cover individuals who offer a “down payment,” even if that payment only covers part of the first month’s premiums.
— In a press release, HHS said it was also “strongly encouraging insurers to treat out-of-network providers as in-network to ensure continuity of care for acute episodes or if the provider was listed in their plan’s provider directory as of the date of an enrollee’s enrollment.”
— HHS is also “strongly encouraging insurers to refill prescriptions covered under previous plans during January.”…
Of course, for insurers who have spent years designing plans to comply with the law, this would present huge and unreasonable logistical hurdles.
To put it slightly differently:
At this point HHS may as well ask insurers to simply declare everybody in America covered http://t.co/G1VyAv1hcg
— Philip Klein (@philipaklein) December 12, 2013
Would all/any of these new fixes be illegal if HHS flatly required them? I realize it’s gauche at this point to ask whether the King can rightly suspend elements of the law that are inconvenient to him, but I feel obliged to put it out there. Maybe that’s why they’re merely being “suggested” instead of mandated — if the insurers extend the deadlines “voluntarily” (wink wink) then there are no legal implications. My hunch, though, is that the fixes are being made optional more for CYA reasons than for legal ones. If HHS mandates them — and according to CNBC, they might yet mandate an enrollment extension if Healthcare.gov has another meltdown — then next month’s havoc can be laid squarely on them. If they merely suggest them, then the havoc is really kinda sorta the fault of insurers who should have done a better job gauging whether extending the deadlines were feasible. And if an insurer decides not to extend the deadline and people are angry that they weren’t able to enroll in time, well, then that’s just a bad-apple insurer showing why they’re a bad apple.
In other news today, because Healthcare.gov’s doing so amazingly well now, HHS announced that they’re going to extend the deadline for phasing out state high-risk pools from December 31st until January. Even some sick people, who have the strongest incentive to transition to the new exchanges, can’t get enrolled in time.