Thursday, June 27, 2013

New Report Compares the Challenges Faced with the Implementation of Part D and the Affordable Care Act

The Center on Health Insurance Reforms (CHIR), based at Georgetown University’s Health Policy Institute, recently released a report discussing the challenges that led up to the launch and implementation of Medicare Part D, the prescription drug program delivered exclusively through private plans, and ways in which state and federal officials working on the Affordable Care Act’s (ACA’s) health insurance exchanges can learn from Part D implementation. The report, written with support from the Robert Wood Johnson Foundation (RWJF), acknowledges that while past efforts to design and launch Part D were far from perfect at the outset, the program is overall a success.

According to the CHIR report, state and federal officials implementing Part D faced several challenges, including unfavorable public opinion of the program, uncertainty about plan participation, high projected costs for consumers, concerns from states, and a need for consumer assistance and post-enrollment complications. At the launch of Part D, more people had an unfavorable opinion of the new program than a favorable one, but just one year into implementation, people began to react more positively—initial public opinion of the ACA was also low, and it may be that public opinion will take a similar turn for the better once the exchanges have been implemented. Beneficiary advocates were concerned that Part D would create high premiums. However, program costs were lower than actually projected, and they remain lower than initial projections. Some policymakers have predicted “rate shock” that will create exorbitant premiums for plans through the exchanges. However, with federal premium and cost-sharing subsidies being applied to most consumers using the exchanges, it is possible that the fear of rate shock may be overstated.

Medicare Part D faced considerable challenges educating beneficiaries about the program, and similarly, efforts to educate the public about the health insurance exchanges have been unsuccessful, according to the CHIR report. While a major public education campaign is slated to begin this summer, policymakers should learn from Part D implementation and ensure that consumers have access to information about the exchanges, including access to consumer assistance such as written materials, online tools, call centers, and in-person counseling.

Read the CHIR report.

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