Jan. 29—Despite signs that insurance signups through the healthcare overhaul have increased, the Obama administration is urging hospitals to step up their enrollment assistance efforts during the final weeks of open enrollment.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius said during a Jan. 23 webcast for hospitals that more of those providers need to help people enroll through the new coverage options offered by the Affordable Care Act (ACA). Specifically, she urged hospitals to enroll staff in the certified application counselors (CAC) program, through which HHS provides training for enrollment assistors.

“I hope that associates that haven’t quite taken on that active role will think about it,” Sebelius said.

Some hospitals and health systems have balked at participating in the CAC program because they have to bear the full cost of dedicating staff to enrollment and because the training and approval process is time-consuming.

Judy Rich, CEO of Tucson Medical Center in Arizona, said on the webcast that her organization viewed the cost of participating in the CAC program as offset by the lower number of uninsured that would require charity care at her facility.

Sebelius also urged hospitals and health systems to provide information and outreach to their communities to spread awareness of the availability of coverage through the ACA. 

Such outreach has taken on growing importance as the March 31 end of the ACA’s first open enrollment period draws closer. An indication of the remaining enrollment challenge came when a recent national survey found only 45 percent of respondents knew they needed to obtain insurance by March 31 or face a tax penalty under the law.

Despite those challenges, nearly three million people have signed up for private health insurance coverage through the ACA, HHS announced Jan. 24. It remains unclear how many have actually activated that insurance by beginning to pay their premiums.

Among the unresolved enrollment issues hospitals continue to wrestle with is whether they are allowed to subsidize patients’ marketplace plan coverage. Amid conflicting direction from the Obama administration on hospital-provided premium subsidies, some hospitals are moving ahead with such initiatives. 

Medicaid Grows

Additionally, more than 6.3 million applicants were found eligible to enroll in Medicaid or CHIP by the end of the year. It was unclear how many of those were newly eligible or qualified under the ACA’s eligibility expansion.

Medicaid enrollment under the ACA, which continues throughout the year, also has received renewed attention from the administration. On Jan. 24, hospitals and health systems received additional guidance on the use of presumptive eligibility, through which those providers can enroll patients who appear to meet their state’s eligibility requirements beginning in January.


Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter: @rdalyhealthcare.

Publication Date: Wednesday, January 29, 2014