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106,185 enroll in health plans through ACA during October

Posted on November 13, 2013 | Comment (1)

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Today, the US Department of Health and Human Services (HHS) issued the first set of enrollment statistics for health insurance plans offered through the Affordable Care Act’s (ACA) Marketplaces.  The report stated that 106,185 individuals signed up for coverage during the first month of open enrollment.  About 75% of these individuals enrolled through State-Based Marketplaces.  The remainder, about 26,000 people, reside in a state in which the Marketplace is operated by the federal government.  While these individuals have completed the enrollment process, they have not necessarily purchased a plan.

Comment (1)

The Congressional Research Service (CRS) issued a new report containing frequently asked questions (FAQs) concerning healthcare.gov contractors. Given the rocky roll out of healthcare.gov, CRS intended to answer common questions about the role of contractor procurement and performance. The CRS report explicitly highlights that questions are answered in general terms in an effort to protect the rights of the contracted parties and avoid the specifics of each document.
Two reports issued by the Government Accountability Office (GAO) indicate that substantial progress remains in the establishment of the individual and small group health insurance Exchanges, two key components of the Affordable Care Act (ACA). The GAO report focusing on Small Business Health Options Program (SHOP) Exchanges purports that many of the central aspects of the federally-facilitated SHOP Exchanges remain to be completed, including eligibility and enrollment, plan management, and consumer assistance. According to the report, 44% of the key activities the Centers for Medicare and Medicaid Services (CMS) intended to be completed by March 31st, 2013 were behind schedule. Furthermore, the continually evolving role that CMS plays in SHOP development presents a challenge for the agency to meet subsequent deadlines, several of which are very close to the roll out date. Similar to the SHOP Exchange, CMS must still work to develop important aspects of the federally-facilitated individual health insurance Exchanges. One important task that has yet to be completed is the testing of the federal data hub with state and federal partners. According to this GAO report, CMS is still in the process of certifying qualified health plans (QHP) and publicizing this information on Exchange websites. CMS has also delayed Navigator funding by 2 months, which has impacted training activities. GAO reported that CMS has completed risk assessment for potential issues associated with the federal data hub. CMS has also been interacting with states to create contingency plans to facilitate successful Exchange implementation prior to the October 1st enrollment period.
A recent report released by the Government Accountability Office (GAO) analyzed the progress of implementing the Affordable Care Act's (ACA) state-based and partnership Exchanges in six states and DC. GAO found that the greatest challenges to achieving complete implementation by October 1, 2103 lie in IT-related work and financing. Several of the states in the study began working on the IT component of their Exchange prior to the release of federal guidelines, meaning significant changes to IT systems may be necessary in the future. Incomplete information on the federal data hub requirements has also hindered full development of several state IT systems. GAO reported that uncertainties associated with the 2014 enrollment numbers make finances very difficult to estimate. States have also employed several different methods to obtain operating funds for 2015. For instance, Oregon will charge an administrative fee of up to 5% of premiums, based upon the number of individuals that enroll in the Exchange. Nevada, however, will charge between $7.13 and $7.78 per member per month, which will be factored into enrollee's premiums.
The US Department of Health and Human Services (HHS) recently released enrollment figures from October 1st, 2013 to December 28th, 2013 for the Affordable Care Act's (ACA) health insurance marketplace. Below are several of the key findings:
  • Nearly 2.2 million Americans have enrolled in health insurance;
  • About 24% of these individuals are between the ages of 18 and 34;
  • 60% of enrollees selected a silver plan; and
  • 79% of individuals selected a plan with financial assistance.
The most recent Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief provides a detailed breakdown and explanation of the enrollment figures.
Today, the Centers for Medicare and Medicaid Services (CMS) released an interim final rule concerning the enrollment period for health insurance under the Affordable Care Act (ACA). In order to have active coverage as of January 1st, 2014, an individual was expected to enroll into a qualified health plan (QHP) prior to December 15th, 2013. This rule, an outcome of the recent issues with the functionality of HealthCare.gov, enables individuals to enroll in QHPs through December 23rd and pay the first month's premium by December 31st in order to be covered at the first of the year. States are also permitted to set their own cut-off date for enrollment. This rule applies to both the individual and the Small Business Health Options Program (SHOP) in Federally-Facilitated and State-Based Marketplaces. Additionally, the rule formally extends the federal Pre-Existing Condition Insurance Plan (PCIP) through January 31st, 2014. PCIP was designed as a transitional program to ensure that individuals with pre-existing conditions were insured until 2014 when ACA market reforms would be fully implemented. Extending PCIP provides these individuals an additional month to enroll in QHPs to offset issues they may have encountered early on with HealthCare.gov.
Yesterday, the US Department of Health and Human Services (HHS) released a progress report on the administration's recent efforts to fix and improve the Affordable Care Act's (ACA) website, healthcare.gov. The website has been plagued with issues and errors since its debut on October 1st. The document, HealthCare.gov: Performance and Progress Report, outlines all of the improvements and changes made to the website over the past two months. Some of these improvements include fixing over 400 bugs and software issues and updating the server so that the site may be able to host 800,000 visitors a day. The report cites management and collaborations issues, as well as inadequate systems and a multitude of technical software bugs, as key causes of the early site malfunction.
The Center for Consumer Information and Insurance Oversight (CCIIO), within the Centers for Medicare and Medicaid Services (CMS), published an FAQ concerning the open enrollment period for individuals purchasing qualified health plans (QHPs) under the Affordable Care Act (ACA). The guidance states that individuals will be able to enroll in QHPs throughout the entire enrollment period, which lasts through March 31st, and not be subject to the individual shared responsibility payment. According to the ACA, individuals would have to enroll in a plan by the 15th of each month in order for their QHP coverage to be effective at the start of the following month. Individuals that enrolled in plans after the 15th would not be covered for another two months. The issue pertains to individuals that would enroll in QHPs between February 16th and February 28th of 2014. These individuals would not be covered until April 1st, and would therefore be subject to the minimum essential coverage penalty under the ACA (the minimum essential coverage provision states that an individual must pay a penalty if he or she does not have coverage for more than three consecutive months in a year). This guidance removes that snafu in the law and states that CCIIO will provide additional guidance on the issue in 2014.
In an effort to help consumers circumvent the backlog to access plan information on federally-facilitated Marketplaces (FFM), the US Department of Health and Human Services (HHS) posted a list of 17,000 plans and premium rates that consumers may browse to see what options are available in their states. Plans are broken down by metal tier (platinum, gold, silver, and bronze), plan type (HMO, PPO, etc.), and the state and county in which the plan is offered. HHS has provided plan information for health insurance and stand-alone dental plans in the individual and small group markets.
The federal healthcare.gov website is limping along. The Administration has now taken a number of steps to begin to quickly and decisively address the problem, including adding a “surge” of technology experts to their contract teams and appointing a high-level overseer with extensive business management expertise. But fixing the website could take a long time...
Since the Act was signed into law on March 23, 2010, the Obama Administration has published more than 70 final rules implementing its provisions (See Appendix A). These final rules, which range from health insurance market reforms to regulation of the nutritional information available on food packaging, breathe life into the Act’s broad policies...In any law as large and complex as the ACA, it is inevitable that certain important policy issues still await resolution. The issues identified here do not impede implementation. But they are important issues nonetheless, and their resolution will strengthen health reform as it moves forward...
Since the Act was signed into law on March 23, 2010, the Obama Administration has published more than 70 final rules implementing its provisions (See Appendix A). These final rules, which range from health insurance market reforms to regulation of the nutritional information available on food packaging, breathe life into the Act’s broad policies...In any law as large and complex as the ACA, it is inevitable that certain important policy issues still await resolution. The issues identified here do not impede implementation. But they are important issues nonetheless, and their resolution will strengthen health reform as it moves forward...