As of the end of November, the fate of the implementation of the Affordable Care Act’s (ACA’s) health insurance marketplaces, and the various deadlines facing consumers and insurers over the next few months remain uncertain. The NHF Public Policy team continues to closely monitor implementation of the ACA on both federal and state levels.
Here are a few issues we want to highlight for the community:
- While many (but not all) tech problems with www.healthcare.gov have been resolved, and the website’s capacity is increasing, it seems unlikely that the Obama administration will be able to meet its deadline of November 30th for the website to be fully functional. In fact, “success” for healthcare.gov may mean that up to 20% of users continue to experience errors. Remember: you can also apply for health insurance using the toll-free number (1-800-318-2596), via a paper application, and through insurance agents and brokers. To locate help in your area, go to: https://localhelp.healthcare.gov.
- The experience in states with state-based marketplaces varies widely. In some states, such as Kentucky, the process is going relatively smoothly and people have been successfully enrolling in both private health insurance and Medicaid plans online. In other states, such as Oregon, no one has been able to enroll in a plan either online or by mail. If you are in a state setting up its own marketplace, other enrollment options besides the website, such as mail and phone, are available.
- The Obama administration recently announced that it has delayed the deadline to enroll in a plan for coverage beginning January 1, 2014, to the new date of December 23, 2013 (a week later than the previous December 15, 2013, deadline). Unless there are more delays, you must enroll in a plan by December 23, 2013, for coverage to start on January 1, 2014.
- A recent policy change was announced after some people were told that their insurers canceled their plan for 2014. This happened, in part, because of the new ACA requirements that plans must meet, causing some insurers to cancel plans that did not meet the new rules. These recent policy cancellations caused an uproar, especially since President Obama had previously promised, “if you like your plan, you can keep it,” As a result, he announced that the federal government is giving states the option to allow 2013 plans to be offered next year if they choose. The number of states choosing to allow plans to continue to be offered and the insurers that will follow suit is still unknown.
If you are affected by this change in policy, and have the opportunity to keep your plan into next year, please remember that your plan does not have to meet ACA requirements, such as elimination of pre-existing conditions exclusions and annual limits. With that in mind, you may want to consider exploring marketplace plans even if you can renew your current plan.
- As a result of the technical difficulties, some state high-risk pools will continue to offer coverage into 2014. Please note that if you choose to stay on your high-risk pool plan for now, but then need to transition to a marketplace plan at some point in 2014, you will likely have to meet a second deductible and will have to reach a second out-of-pocket maximum. For some people, it may make financial sense to transition to a marketplace plan immediately in 2014, rather than staying with the high-risk pool.
- As of today, open enrollment in marketplace plans is scheduled to end on March 31, 2014. This is also the deadline to enroll in a health insurance plan (via the marketplace or outside of it) to satisfy the individual mandate and avoid paying the penalty--$95 or 1% of your income, whichever is greater.
Given the ongoing technical issues, some in Congress are calling for a delay of the individual mandate until 2015 and other changes to the open enrollment period. It is not clear whether there will be additional delays and extensions with www.healthcare.gov and state marketplaces. The NHF public policy team will continue to monitor implementation. We encourage you to contact us if you have questions. Please check the NHF advocacy page for additional implementation resources and webinar recordings.
