If the administration solves the problems before the end of October, “this would just be a blip on the radar,” said Dan Mendelson of consulting firm Avalere Health in Washington.
If problems cannot be resolved that quickly, Mendelson said “there are other options for getting people enrolled,” noting that Medicare beneficiaries signed up for coverage for decades without using computers.
The president also mentioned those options Monday, saying consumers could sign up by telephone, in person with trained assisters or by downloading an application and mailing it in.
But those options are not ideal, mainly because millions of applications would have to be manually checked across several federal agencies.
“That would take significantly longer than if it was automated,” said Schuyler. “While it’s a fallback, it’s not going to resolve the issue that if Healthcare.gov doesn’t improve in two or three weeks, we’re going to have this backlog of people who are trying to enroll.”
Consumers have until Dec. 15 to enroll for coverage that starts Jan. 1, although the open enrollment period goes to March 31.
Some analysts suggest that if problems persist into late November or December, that the Obama administration will need to consider extending the open enrollment period.
Such a decision, however, would have political and financial ramifications.
Republicans are already seizing on the troubles as a way to advance their effort to delay or eliminate the law, and may obstruct changes that require congressional approval.
Insurers may not support a longer enrollment either, said Antos. That’s because a later deadline means more time without premium revenue coming in from potential healthy customers while costs mount from providing care to sick customers, who probably signed up before Jan. 1, he said.
Extending the enrollment period could also lead to a domino effect, bolstering efforts by Republicans and other critics of the law to delay the fine for those who fail to sign up for coverage. With some exceptions, nearly all Americans are required to have insurance next year, or they face a penalty of $95 or 1 percent of their household income.
In addition, it could hurt public perception of the law and of the federal government, said Geoffrey Joyce, director of health policy at the Schaeffer Center for Health Policy and Economics at USC.
“From a political standpoint, it just shows that this is not working well and it gives fuel to the opposition,” he said. “It doesn’t build confidence that these people know what they are doing.”
Others, however, are less concerned about a slow start. “The law would not reach its target of insuring as many people as possible,” said Carter Price, a mathematician at the Rand Corporation. “But [the federal government] will get a second chance the next year if things don’t go off as planned the first year.”
Mon, Oct 21 2013