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Mar. 26—The Obama administration is extending open enrollment in health insurance plans sold in troubled federally operated marketplaces for applicants who attest that they were unable to complete their applications, the Obama administration announced Wednesday.
Although many details remain unclear, an enrollment extension for the marketplaces is similar to extensions allowed at the end of 2013, which enabled about 20,000 more applicants to obtain coverage, an administration official said. Enrollment in the federal marketplaces— created by the Affordable Care Act (ACA) to provide insurance to people in 34 states–was scheduled to end for all applicants on March 31.
Enrollment will be extended for people who “self-attest” that they had begun applications on healthcare.gov by March 31, but were unable to complete them. When reporters asked an administration official Wednesday whether the government planned to audit such attestations or issue penalties to applicants who are later found to have lied in their attestations, the administration official declined to respond.
“The reality is that consumers have to attest to the fact that they were eligible for this coverage,” Julie Bataille, a spokeswoman for the Centers for Medicare & Medicaid Services, said in a call with reporters. “It’s also important to recognize that this is an official federal application for marketplace coverage, and most people are truthful when applying for those benefits.”
Bataille and other administration officials declined to specify whether there is a cutoff date for enrollees to complete their applications.
Any insurance bought by April 15 will go into effect May 1. Phone centers also could provide extensions, according to administration officials..
“Open enrollment ends March 31,” Bataille said in a written statement. “We are experiencing a surge in demand and are making sure that we will be ready to help consumers who may be in line by the [March 31] deadline to complete enrollment—either online or over the phone.”
The latest change to ACA enrollment policies was expected to cause some problems for insurers, which have struggled to absorb a range of administrative changes in recent weeks aimed at easing applicants’ enrollment.
"These types of last minute changes do complicate enrollment for health insurance plans and will require manual workarounds to accommodate,” said Rick Gundling, vice president, healthcare financial practices for HFMA. “Obviously, an extension would be more problematic if it continues for a long period."
Bataille said the extension is similar to the extension in December 2013, during which applicants to healthcare.gov were repeatedly given more time to enroll in coverage and have it activated on Jan. 1. The push for coverage to activate by the beginning of the year aimed to avoid lapses in coverage, since policies many policies ended at the end of the calendar year.
The previous delay applied only to applicants who had started the sign-up process and had been unable to complete it by the previously established deadlines.
Other components of the latest enrollment extension include allowing people with “special circumstances and complex cases” more time to receive help completing the enrollment process, according to an official. The ACA already allowed enrollments for specific changes in circumstances throughout the year, such as divorce, and CMS plans to issue guidance on more situations where people could sign up outside of open enrollment.
The administration originally projected that it would enroll 7 million during the marketplaces’ initial open enrollment period, but has scaled that figure back to a projected 6 million enrollees due to the website’s massive technical failings. Some industry experts remain doubtful sign ups even will meet the new lower target of 6 million enrollees by March 31.
Enrollments were similarly extended by some of the 16 states that are operating their own marketplaces, including Maryland, Minnesota, and Oregon.
It remained unclear whether applicants who sign up for qualifying coverage after the end of open enrollment will owe tax penalties under the ACA's individual mandate.
The large numbers of delays in various requirements of the law aim to offset massive technical failings in the federal and some state marketplace enrollment websites that have been mitigated in recent months but continue in various ways.
Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter @rdalyhealthcare.
Publication Date: Wednesday, March 26, 2014
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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