November
3, 2014
It's
time to get ready for round two of Obamacare. Open enrollment
in PPACA plans runs Nov. 15-Feb. 15, and there's plenty that's changed since
last year. Here are some things you need to know.
Enrollment numbers,
efforts
The
Obama administration announced that PPACA had 7.3 million
paying enrollees as of mid-August, down from the 8 million
figure they announced at the end of enrollment in April.
So far, the
administration has made no enrollment targets this year.
Remember these pointers
as you work to get the most from your enrollment season.
Despite
the drop in paying enrollees, the administration still has made a great dent in
the number of uninsured in the country. Gallup numbers
put the uninsured rate at 13.4 percent, the lowest on record,
and largely attributable to PPACA.
But
the remaining uninsured may be especially hard to reach. According to Kaiser
Family Foundation, the remaining uninsureds have been without coverage for
years, and experience many barriers to getting it. Lack of awareness is one.
According to a survey from the Transamerica
Center for Health Studies, for example, nearly half of those who
remain uninsured say they still haven't heard of the individual mandate, the
law's provision requiring them to get health insurance. And 43 percent haven't
heard of the exchanges where they may be eligible to purchase health insurance.
Thousands more consumers
who had their non-PPACA compliant plans cancelled may also be shopping for
coverage this year.
Other challenges exist as
the public is less interested in buying health coverage through the public
exchanges during the law's second enrollment period, with likelihood of
consumers buying PPACA plans dropping 19 percentage points from last year,
according to a poll by the Morning Consult.
Plus there is a time
crunch — the second round of open enrollment lasts only three months, about half
the time as last year.
That's
why groups, such as Enroll America
— a nonprofit formed in 2011 to get the word out about PPACA — are amping up
efforts by hiring more help to reach out to those without health coverage.
HHS also has thrown hundreds of
millions of dollars more at enrollment efforts this year.
Fines
Last year, the penalty
for not having insurance was $95 or 1 percent of household income, whichever
was higher.
Those fees increase in
year two: Those without insurance face a fine of $325 per person or 2 percent
of income, whichever is larger.
Those
higher fines might spur more sign-ups, some industry experts say. But at the
same time, cost concerns still plague many without coverage. Among consumers
still uninsured as of June, nearly 60 percent said they couldn't afford
coverage, according to a recent analysis by the
Urban Institute.
Remember these pointers
as you work to get the most from your enrollment season.
Auto enroll
The majority of those who
enrolled in PPACA plans through the exchanges will be auto-enrolled in the same
health plan they selected in 2014 this coming enrollment period, as well as
receive the same subsidies, if applicable.
The
administration announced the law's new auto-enrollment
feature back in June as a way to simplify the enrollment
experience for consumers.
The new option may also
alleviate some of the technical difficulties that have plagued HealthCare.gov
during the tumultuous first year of enrollment, as well as give the
administration a head start on the increasing number of Americans getting
coverage under the law.
Consumers who are
automatically re-enrolled in PPACA plans will still have the option of changing
plans during open enrollment, according to officials. Enrollees also can return
to the system to report life changes.
Even if someone is no
longer eligible for a subsidy, they will still be auto-enrolled in their
current plan, just without a tax credit, HHS says. State-based exchanges may
also take this approach, HHS says, or may propose an alternative.
Industry experts warn that consumers need
to review their previous plan or else they might face increased costs.
More carriers
More carriers
are jumping on board to join PPACA's exchange offerings. Nearly
80 new carriers will participate in PPACA's marketplace this year, increasing
the number of participating carriers by 25 percent, federal health officials
say. In total, 77 new carriers will offer coverage when open enrollment for
PPACA begins Nov. 15.
The 77 new carriers will
be joining those that sell plans in 43 states and the District of Columbia
where data about insurance participation was available, HHS says.
HealthCare.gov will get
the bulk of the new carriers: 57 carriers will join the federal exchange,
bringing to the total up to 248 carriers, a 30 percent increase. Meanwhile, the
eight state-based exchanges where data is already available will have a total
of six more carriers in 2015, a 10 percent net increase over this year.
Remember these pointers
as you work to get the most from your enrollment season.
HHS notes that four
states out of the 36 on HealthCare.gov — Indiana, Missouri, New Hampshire and
West Virginia — will at least double the number of insurers that sold plans
there this year. And 36 states nationally will get at least one new carrier.
Last year, a number of
major carriers — including UnitedHealth, the nation's largest carrier —
proceeded with caution onto the exchanges during its first year either limiting
participation or not participating at all, for fear the earliest enrollees
would be sicker.
UnitedHealth
recently said it will participate in about two dozen exchanges
in 2015 after selling in just five this year.
HHS says their data
“demonstrates that the marketplace is working to increase competition and lower
costs for consumers.”
Specifically, the agency says, an increase
of one carrier in a rating area is associated with a 4 percent decline in the
second-lowest cost silver plan premium, on average. In 2014, consumers in
regions with larger numbers of issuers were able to access a wider range of
choices.
New management
There's no guarantee that
HealthCare.gov won't suffer from the same problems and protest it had last
year, but there's now a new face behind the operation.
The
administration announced in
August that Kevin Counihan, former leader of Connecticut's
exchange, will take the reins of HealthCare.gov in his new role as Marketplace
Chief Executive Officer.
Remember these pointers
as you work to get the most from your enrollment season.
“We are building strong
teams with the focus and know-how necessary to advance our mission and deliver
impact for the people we serve,” HHS Secretary Sylvia Burwell said in late
August when announcing the position. “We are committed to instilling ongoing accountability
for reaching milestones, measuring results and ensuring a successful open
enrollment period.”
According to an HHS
statement, in his new role, “Counihan will be responsible and accountable for
leading the federal Marketplace, managing relationships with state
marketplaces, and running the Center for Consumer Information and Insurance
Oversight, which regulates health insurance at the federal level. He will
report to CMS Administrator Marilyn Tavenner.”
Counihan has had success in this arena: Connecticut's
state exchange has been one of the most successful in the nation, succeeding
enrollment projections. Access Health CT signed up about 79,000 people for
coverage through Connecticut's exchange, while another 120,000 gained Medicaid
coverage. Since 2012, the state's uninsured rate has been cut nearly in half,
from 7.9 percent to 4 percent.
Security issues
Despite some strides made
by the Centers for Medicare & Medicaid Services within the last year, a
recent report from the Government Accountability Office detailed continued
privacy and security weaknesses on HealthCare.gov.
“While CMS has taken
steps to protect the security and privacy of data processed and maintained by
the complex set of systems and interconnections that support Healthcare.gov,
weaknesses remain both in the processes used for managing information security
and privacy as well as the technical implementation of IT security controls,”
the GAO report says.
Specifically, GAO says,
the CMS has not always “required or enforced strong password controls,
adequately restricted access to the Internet, consistently implemented software
patches, and properly configured an administrative network.”
Related
Remember these pointers
as you work to get the most from your enrollment season.
The GAO also detailed six
recommendations for HHS to protect privacy on the federal exchange but it
remains to be seen if those issues have been resolved.
Reports
over 2015 premium costs
have fluctuated wildly. Recent research and approvals, though,
has pointed to modest increases in most major markets driven by increased
carrier competition.
The question over the legality of PPACA's
subsidies — spurred by two contradictory court rulings in July — is also
creating a big unknown in PPACA plans. But with numerous appeals expected in
those court decisions, the legality of subsidies shouldn't play much into this
year's enrollment — at least not yet.
http://www.benefitspro.com/2014/11/03/what-to-know-about-ppacas-second-enrollment-period?eNL=5459606b160ba03b5855e6d5&utm_source=BenefitsProDaily&utm_medium=eNL&utm_campaign=BenefitsPro_eNLs&_LID=144817897
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