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Many will be automatically re-enrolled in ACA plans


 

AT THE AHIP HEALTH INSURANCE EXCHANGES FORUM

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WASHINGTON – Unless patients actively choose a new plan before Dec. 15, those who paid for a health insurance plan through the federal marketplace in 2014 will be automatically re-enrolled in the same plan for 2015, federal officials said.

The goal is to ensure there will be no gaps in coverage, Kevin Counihan, CEO of the federal health insurance marketplace, said at the Health Insurance Exchanges Forum held by America’s Health Insurance Plans.

Kevin Counihan

Kevin Counihan

Mr. Counihan did not give an estimate on how many people might be automatically re-enrolled, but he did say that some 7.3 million Americans had selected and paid for a health plan through the federal marketplace.

Mr. Counihan was appointed in late August to oversee the operations of healthcare.gov, the web portal for the federal health insurance marketplace. He is also director of the Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight.

Open enrollment for health plans offered under the Affordable Care Act begins Nov. 15.

The CMS is starting to send notices to patients who either enrolled in a plan in 2014, or had been determined to be eligible but did not enroll, reminding them that they can start the renewal process on Nov. 15. The notices will arrive by mail or e-mail, depending on what the patient indicated as a preference.

At the same time, patients will receive notices from their current insurers, letting them know whether there are network or benefits changes, or if there is an increase or decrease in the premiums or other costs.

Patients have until Dec. 15 to enroll in a plan for coverage that starts on Jan. 1.

If they do not renew a current plan or elect a new plan by Dec. 15, they will be automatically re-enrolled in the existing plan, said Ben Walker, director of open enrollment for the federal marketplace at the CCIIO.

They will get the same amount of advance payment of the premium tax credit and same subsidies as in 2014. Those credits and cost-sharing reductions are subject to change, depending on a patient’s updated eligibility information.

Even if they’ve been auto-enrolled, they can eventually go back and select a different plan, as long as they do it by Feb. 15, when open season ends, Mr. Walker said at the meeting. The coverage in the new plan will start on the first day of the next or second month depending on when the patient enrolled.

The National Governors Association is somewhat concerned about the automatic re-enrollments, Esther Krofah, program director in the NGA’s health division, said at the meeting. “We have to make sure consumers are aware of their options and are taking the steps they need to protect themselves,” she said.

Rachel Klein, organizational strategy and enrollment program director for Families USA, said that patients could be confused, or potentially harmed, by the automatic re-enrollment. In some cases, they might want to stay with the plan, especially if they’ve developed a relationship with a physician in that plan’s network, she said.

But they may also have gotten a new diagnosis that requires them to see a particular doctor, who might not be in the plan, said Ms. Klein. For that reason, it will be especially important for patients to be able to “compare in much greater detail the plans available,” she said.

To help increase awareness of the re-enrollment process, the CMS on Oct. 15 launched the “Five Steps to Staying Covered” campaign, urging patients to review their current plans, and then, starting on Nov. 15, to update their income and other information, compare the current plan with other plans, choose a plan, and enroll.

The CMS has been testing the healthcare.gov website and is encouraged by what it has seen so far, Mr. Counihan told health plan representatives.

“We feel confident we’re going to have a successful 2015,” he said.

aault@frontlinemedcom.com

On Twitter @aliciaault

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