Obamacare allies are already plotting how to make 2015 enrollment better


(Photo by Mike Segar/Reuters)

Today's a pretty good day for Obamacare advocates after the news that 7 million people signed up for exchange coverage by yesterday's deadline. But they’re already thinking about how to improve open enrollment for 2015 health plans, which is scheduled to start Nov. 15.

As a reminder, the 2014 open enrollment period isn’t technically over. The feds and state-run exchanges are making accommodations for people who had trouble signing up before the March 31 deadline. We’re not sure how many people will try to enroll, but it’s reasonable to expect the sign-up numbers will increase over the next couple of weeks.

The health-care advocacy group Families USA, a strong White House ally, this afternoon issued 10 recommendations for boosting enrollment next year. The recommendations touch on things like affordability of coverage, increasing enrollment resources and just making the sign-up process simpler. All of these recommendations, the group says, can be done without legislation.

It's worth remembering that the enrollment window for 2015 is supposed to be just three months long, half the time for 2014 enrollment. And the Congressional Budget Office is projecting that 13 million will enroll in exchange plans in 2015, almost double what 2014 enrollment will turn out to be.

Some of the advocates' major recommendations:

  • More navigators: The navigator program, included in the law to educate people about enrollment options, was funded at $67 million this year for 34 federal exchange states. Those states had fewer resources for in-person help than the state-run exchanges did, and it shows in the enrollment figures. "It is clear that a very large percentage of those people who wanted to get enrolled need help with the enrollment process,” said Families USA Executive Director Ron Pollack. The administration is expected to soon announce the next round of funding for navigators, but Republicans have been extremely critical of the program -- for purely political purposes,  Obamacare supporters say.
  • Align enrollment with tax-filing season: This is an argument that tax preparers have been making all along. The 2015 enrollment period is scheduled to end Feb. 15, well before most people get their tax returns and might have some extra cash to purchase insurance. It’s also before people may learn for the first time next year whether they triggered the mandate penalty. The advocates say the enrollment period should be extended through April 15, the deadline for filing taxes.
  • Increase availability of low-deductible plans: There’s been some hand-wringing over the high cost-sharing features in 2014 health plans and whether people believe they can afford coverage. Consider that the average deductible for a silver-level plan, the most popular in the exchanges, is about $2,500, according to Families USA. “Many Americans also don’t like high-deductible plans and … this is a deterrent to them actually getting care,” said Cheryl Fish-Parcham of Families USA. The group is asking HHS to encourage plans that would cover more routine services before people would have to pay their deductible.

There are also recommendations in the report about streamlining the enrollment process, making more enrollment materials available in other languages, and significantly reducing the impact of the ACA’s allowed surcharge for tobacco users.

Obamacare is a work in progress. The next few months are going to be key for reviewing what worked, what didn’t and how the experience can be improved in future years.

Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
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