More than a month after Max Baucus, D-Mont., an early proponent of health reform, said the implementation of state-based health insurance marketplaces was going so poorly that a “train wreck” would ensue, the Obama administration is now launching a public relations effort aimed at teaching consumers how to buy marketplace coverage.
Marketplaces are supposed to be up and running by Oct. 1, capable of selling full health insurance coverage to individuals and small businesses. Since millions of people will be applying for coverage on those marketplaces (with coverage taking effect Jan. 1, 2014), the government increased its public outreach efforts in the last 100 days before this keystone feature of reform takes effect.
The new outreach materials are geared to helping with enrollment and describing the consumer-protection aspects of health reform (such as guaranteed issue, no rescission and an end to underwriting for factors other than smoking, geography and age).
The crown jewel of this is the newly revamped healthcare.gov website, unveiled June 24. On the updated site, consumers also will get answers to frequently asked questions, search engine features and a customer service number that will be running 24 hours a day, seven days a week, the White House and the U.S. Department of Health and Human Services announced. (The Spanish version of the site, CuidadoDeSalud.gov is being updated as well.)
At this Internet location, the Centers for Medicare and Medicaid Services placed a trove of documents to help states, small businesses and consumers tell the public about the new exchanges. These include the employer application form to the Small Business Health Options Program. There are also fact sheets; for example, “Things to Think about When Choosing a Plan” and “Helping Consumers Apply & Enroll through the Marketplace;” drop-in articles, including “Are You Ready? The Health Insurance Marketplace is Coming;” short messages on open enrollment and other key dates; public service announcements for radio broadcast; as well as flyers, posters and other media.
Exchange Notices
Employers with more than one worker and doing more than $500,000 of business per year must inform their workers of the existence of exchanges — including coverage options — by Oct. 1, 2013. Last month, the U.S. Department of Labor/EBSA issued separate model notices in English for: (1) employers that offer a health plan; and (2) employers that do not offer a health plan. EBSA has now posted comparable notices in Spanish.
Will This Game of Catch-up Work?
This comes on the heels of a Congressional report showing that state-run and federally facilitated exchanges will not be ready for action on Oct. 1 because so many interim deadlines were not being met. In particular, some 44 percent of the key activities CMS initially targeted for completion by March 31, 2013, were behind schedule, a June 2013 Government Accountability Office report stated.
GAO reported that many key activities are incomplete and some are behind schedule. Core functional areas where progress was incomplete included:
- eligibility and enrollment (that is, development and testing of IT systems to determine eligibility and to enroll consumers);
- plan management (primarily review and certification of qualified health plans that will be sold on exchanges); and
- consumer assistance, such as funding and development of the navigator program in state exchanges with federal involvement, to give small employers enrollment assistance and outreach.
In the report, 18 states reported lagging behind in a significant number of projects that need to be completed, preferably by Oct. 1. These included signing data agreements, training call center personnel, publishing eligibility applications, launching branding and marketing campaigns, posting plan options online and designing complaint-tracking systems.
Another indication of lagging preparedness is the recent final rule allowing insurers to put only one variety of coverage up for sale on the SHOPs. The requirement to offer four levels of coverage (bronze, silver, gold and platinum) will take effect in 2015; not 2014 as originally planned. Likewise, employers will not need to offer multiple levels of coverage to employees until 2015.
CMS replied that missed interim deadlines still did not reflect often significant progress states and feds had been making on these exchange setup activities, and it expressed confidence that exchanges will be open and functioning in every state by Oct. 1. Go here to see the GAO report.