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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