The federal agencies implementing health reform continue to delay aspects of roll-out, especially as they relate to state-based health insurance marketplaces (also called “exchanges”), which are supposed to be up and running on Oct. 1.
The Obama White House announced on Sept. 27 that federally run health-insurance exchanges, required by health care reform, will not be able to handle Spanish-language online enrollment by Oct. 1 as planned. The announcement did not apply to the 14 states that run their own exchanges. It also told the public that the exchange program for small businesses will have no online component until Nov. 1.
On the same day, a prominent administration official described how responding to industry concerns played a role in implementation delays the public is seeing now.
Spanish Not Spoken Here
First, the Spanish-language version of healthcare.gov will not be able to enroll Spanish speakers online until Oct. 21, the administration announced.
Spanish speakers will still be able to enroll through a call center or enrollment specialists known as “navigators,” the White House said. It added that this was not a delay, but rather reflected the administration’s decision to unveil the online enrollment tool to coincide with Hispanic Heritage Month, according to Kaiser Health News.
Another Delay
Second, small businesses (those with 50 or fewer workers) will not be able to sign their staff up for insurance on Small Business Healthcare Option exchanges until Nov. 1, the U.S. Department of Health and Human Services admitted, also because the SHOPs’ online resources are not up and running. Online enrollment will commence on Nov. 1.
That means small businesses will not be able to access searchable coverage options with premium quotes, and the concept of “one-stop shopping” will not be available until Nov. 1. However, they can apply to establish their eligibility and to get subsidies to cover their workers, White House spokesperson Jay Carney said. He added the failure to have online resources ready on Oct. 1 would have no practical effect on coverage because policies sold on SHOP exchanges won’t be valid until Jan. 1 in any event.
Carney further downplayed the delay, noting that the SHOP exchange is open year around, while the larger state-based health insurance exchanges for individuals stop selling policies at the end of March.
But the delays add to expectations of a slow start to the landmark social program which remains under attack by Republican leaders and faces formidable technical hurdles for both states and the federal government, Business Insurance reported.
EBSA Explains About-face on Exchange Notice
Also on Sept. 27, Assistant DOL Secretary for the Employee Benefits Security Administration Phyllis Borzi described what complicates reform implementation: Some of it has been in response to disinformation generated in the market and in the media.
For instance, the agency had to do a “quick pivot” on the notice about exchange coverage employers are required to give all employees.
Employers were concerned that their participants were getting erroneous information from vendors offering to sign up people on exchanges, but that inaccuracies in their marketing would contribute to participants leaving employer plans, Borzi said.
In response, EBSA/ DOL added an optional section to the two model notices EBSA/DOL issued (one for employees covered, another employees not covered by an employer plan) with its approved description of the exchanges, hoping that would correct misconceptions. Use of the language is optional, but the additional description helps employers accurately describe the exchanges to their workers, she said.
There was a second set of disinformation: one consultant issued statements that failure to distribute the notice of exchange would trigger $100-a-day penalties under ERISA Section 502. That mistake went viral and “that started a stampede that failure to distribute would result in $100 a day ERISA fine.” DOL/EBSA responded with another clarification that the notification requirement is authorized under the Fair Labor Standards Act and as such it does not carry with it the threat of ERISA administrative fines.
This clarification is found in the recent agency-issued FAQ saying that while the notices are required, there is no penalty for failing to distribute them. On the other hand, Borzi said, since the notifications are not incorporated in ERISA, but part of the FLSA, employers must give them to all employees, not just people covered by the company health plan.