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Health Insurance & Affordable Care Act

Administration Tests Fixes That Would Allow Insurers, Brokers To Enroll More Consumers


The way that is supposed to work in the 36 states served by the federal website is that consumers who start out on an insurer’s or online broker’s website are automatically transferred to to determine if they qualify for a subsidy, then transferred back once that information is confirmed. Often, that transfer has gotten caught up in the error messages and other difficulties that have plagued the federal website since it opened Oct. 1.

“What they need is a way … to get a subsidy eligibility determination without having to go through the whole rigmarole,” said Dan Mendelson, CEO of Avalere Health, a Washington D.C.-based consulting firm.

Administration officials said last week that steady improvements are being made to, and that waiting times and error messages are well below where they were just two weeks ago. They said they also have made progress in fixing systems designed to let insurers directly enroll subsidy-eligible customers.

While those fixes are still being tested, some industry experts say a better solution might be to allow insurers and brokers to directly connect with the “federal data hub,” the portal through which subsidy calculations are made after applicants’ information is cross checked with several government agencies, including the IRS and Homeland Security.

States running their own online marketplaces already use such a direct connection.

“Please consider directing CMS to allow eHealth to directly connect with the federal data hub, post haste,” eHealth's CEO Lauer said in his letter.

Ehealth officials say they have not heard back from the administration, but are now testing the tweaks the administration has made to the existing system. Still, the current design is cumbersome because it transfers applicants from one website to another and is “is not an optimal way to leverage the experience and expertise” of websites like eHealth, said spokesman John Desser, vice president of government affairs.

But a direct connection between the hub and insurers or brokerages isn't likely to happen because of security concerns, said Dan Schuyler, a director with Leavitt Partners, a Salt Lake City-based consulting firm advising states about their online marketplaces.

"They're not going to let carriers or web brokers have direct access," said Schuyler. "From a security and privacy perspective, it would be an administrative nightmare."

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Sun, Nov 24 2013

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