The Biggest Obamacare Challenge, Year Two

By now, everyone knows that building the website itself was among the chief obstacles that faced the Affordable Care Act before the launch of the Health Insurance Marketplace. Now, as the second open enrollment period in November approaches, you might think that enrollment organizations like Enroll America are feeling secure in the knowledge that HealthCare.gov made it successfully through the first cycle and will be ready to go for the second. You’d be right to an extent – but we do still face a huge technical and logistical challenge for which there is no real precedent: in addition to reaching out to the millions of remaining uninsured who still stand to benefit, we have to make sure the 8 million people who have already enrolled can easily renew and keep their coverage.

And getting that renewal process right is a complex and tricky task. As we laid out in recommendations we made last month, many consumers shouldn’t have to take action to stay covered; namely, those who are happy with their coverage, and whose plans and circumstances aren’t changing, and whose household circumstances haven’t changed. If they do have new information to report, they should only be required to update the relevant sections of their account, not fill out a whole new application. Those whose plans or household circumstances have changed need clear, timely information about their options for coverage and financial assistance, and a streamlined process for getting an updated eligibility determination and transitioning onto their new coverage. But making all of that happen will require a lot of forethought and planning from technical experts, policy makers, enrollment assisters, and insurance companies – trial and error just won’t cut it when health coverage for millions of American families is on the line.

That is why we were so encouraged by the preliminary plan the Department of Health and Human Services (HHS) laid out at the end of June. As we recommended, the proposal will allow the majority of consumers to keep coverage in 2015 without requiring them to take action. That is great news for consumers, and brings federal Marketplace plans into line with the current insurance market, where most consumers are auto-enrolled in their plan each year unless they choose to change or cancel their coverage. Still, many consumers will need to update their marketplace account to ensure they receive the right amount of financial help. In the guidance, HHS also laid out a framework for informing consumers about that process, which is of critical importance given that more than 85% percent of those enrolled received a tax credit to help make their coverage affordable.

The guidance from HHS is a great first step, but real challenges still remain, which is why we’re pleased that they’ve started this conversation early and are asking for input. Different states have different deadlines to send consumers notices about plan changes, and we need to make sure those notices include as much information as possible about a consumer’s tax credit so that they know what they will actually pay. Some in the hospital and provider community have also raised legitimate worries about the formula that determines which plan is most similar if a consumer’s original plan is no longer available.

We’ll be working closely with all our partners in the national enrollment coalition to strengthen these and other aspects of the plan during the public comment period this month. I’m also pleased that representatives from the insurance industry, like the Blue Cross Blue Shield Association, are stepping forward now to help facilitate these discussions between government, the private sector, and the non-profit enrollment community.

Our more than two hundred field staffers in communities across the country are also planning ahead to make sure as many Americans as possible are able to renew their coverage. We’re already holding training calls – and a National Training Day on July 19 – for our thousands of partners and volunteers to educate them about guiding consumers through the renewal process. And as November nears, we’ll be calling back the tens of thousands of consumers who told us they got coverage over the last year to remind them to renew and answer any questions they may have.

While making sure that millions of newly insured Americans can keep the peace of mind that comes with affordable coverage will require a lot of hard work from all of us, there’s nothing more important to ensuring that the second enrollment period is a success. We now have a good framework to work from, a good team in place, and if we keep our eye on the ball we can help millions of Americans not only gain – but retain – coverage in years to come.