Reprinted from HEALTH PLAN WEEK, the most reliable source of objective business, financial and regulatory news of the health insurance industry.
By Patrick Connole, Editor
April 29, 2013 Volume 23 Issue 15
Despite the best efforts of a top CMS official to ease concerns over whether insurance exchanges will be ready to open on time this fall, it seems that nobody will be shocked if just such a delay occurs. Gary Cohen, director of CMS’s Center for Consumer Information and Insurance Oversight (CCIIO), on April 24 testified before a House Energy and Commerce oversight panel, and insisted all systems are go for the new marketplaces. He echoed the sentiments of his boss, HHS Sec. Kathleen Sebelius, who recently told the same panel the same thing.
In between taking blow after blow from intensely disapproving committee Republicans on a range of health reform-related issues, Cohen insisted that states are making good progress to prepare for exchange operations and so is the federal government. “We will see a functioning marketplace on Oct. 1….We will be up and running Oct. 1,” he told lawmakers.
But what else would he say? asks Brett Graham, partner at Leavitt Partners, a Salt Lake City-based consulting firm founded by Michael Leavitt, the former HHS secretary and three-term Republican Utah governor. Participating in the AIS Health Insurance Exchange Boot Camp virtual conference on April 24, he cautioned that no matter what Cohen or other top HHS officials declare now, the jury would be out on the timing and scope of exchanges until the very last minute. His firm contends that the positive talk from HHS has to happen — “otherwise participation by plans and states will be reduced.” Exchanges may open as scheduled, but will likely not be running at the speed anyone envisioned, with Graham recalling a comment by former Gov. Leavitt that it will be like a Formula 1 race car moving at go-kart speed.
No Plans to Reduce Exchange Operations
“I don’t see it being delayed; it is too important for the [Obama] administration,” Graham added, while Leavitt Director Cheryl Smith told the same audience that HHS “has no plans to delay anything until it gets to a make or break moment. I guess we will know on Oct. 1.”
Cohen also deflected suggestions by Republican skeptics that HHS has plans to “de-scope,” or reduce, the full suite of Affordable Care Act programs, with GOP lawmakers citing instances where that has taken place already. These instances include the recent decision by HHS to delay by a year the employee choice provision in the Small Business Health Options Program, congressional repeal of the CLASS Act long-term care program and HHS closing the Pre-Existing Condition Insurance Plan (PCIP) to new enrollment because of funding issues.
In written and oral testimony, Cohen said technical aspects of exchange preparations were also on track. CMS has completed the Data Services Hub’s technical design, a framework for security across agencies and protocols for connectivity, and is now testing the hub with federal and state partners. “The hub will begin officially supporting the verification of applicant information on Oct. 1 when enrollment begins,” Cohen said. At the same time, health plans have been submitting bids to qualify for the marketplaces ahead of an April 30 deadline. “On April 1, CMS began accepting and certifying issuers’ qualified health plans applications to participate in the federally facilitated marketplaces. We will post the qualified health plans’ rate and benefit packages on healthcare.gov when open enrollment begins,” Cohen said.
Outreach Programs Launch Soon
On pricing, he said everyone would have to wait and see what plans submit before any evaluation of 2014 premiums can occur. Over time, however, reform law changes will “absolutely” lead to lower costs, resulting in consumer savings, Cohen said. When questioned repeatedly on the cost outlook, he added that without knowing particulars, “I expect that premiums will go down” eventually in comparison to what they would have been without the reform law.
Separately, an HHS spokesperson tells HPW that the outreach and education program to market the exchanges is under development and will include social media and traditional media campaigns in addition to other efforts. The program will soon launch with the goal of raising consumer awareness about new coverage opportunities available in 2014 and the initial open-enrollment period for health insurance marketplaces this fall. The “Get Ready” phase of work begins in the summer, including additional details about program operations (like Web and call centers) as they come online, as well as training for navigators and certified assisters who will help consumers through the enrollment process.
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