The government had previously delayed the deadline for enrolling in coverage that starts Jan. 1, moving it back from Dec. 15 to Dec. 23 after the Web site's tumultuous launch made it difficult for many to shop. While that deadline will stay the same, shoppers will now have until Dec. 31 to pay their first month's premium.
The Obama administration is also extending coverage under the health-care law's state high-risk pool, which currently covers over 84,000 people with preexisting conditions. That coverage was initially slated to end Dec. 31, but will now run through the end of January to give enrollees more time to transition into health-care law plans.
Much of Health and Human Services' plan is less about new requirements, and more about pushing insurance plans to take certain steps to smooth the transition into new health-care law plans. The administration is "encouraging" insurers to allow people who sign up after the Dec. 23 deadline to start coverage on Jan. 1 -- and urging them to accept payments for those January policies after the first of the month.
"Many do retroactive coverage in the current market," Medicare spokeswoman Julie Bataille said. "We want to continue to work with them. Many of the plans will be interested in making sure they get paid after people enrolled."
Administration officials said that health insurer Aetna had agreed to accept January premium payments through Jan. 8.
HHS has also asked insurance plans to keep refilling prescriptions that were covered under an enrollee's previous policy -- and charge patients' visits for acute conditions to out-of-network doctors as if the physician were part of the health plan.
"This transition opportunity is quite common in the insurance world," Mike Hash, director of the Health and Human Services Office of Health Reform, says. "This is something our partners in the insurance world are wanting to work with prospective members on, to make sure [they don't interrupt] ongoing medical care."
The plan relies heavily on the cooperation of private health insurance plans, who will need to decide whether they will enact the Obama administration's proposed changes -- or, at this late point in enrollment, whether they have the logistical capacity to do so.
One insurance official, who asked for anonymity to discuss the proposal frankly, said the changes did look generally feasible at first glance. The source also expressed frustration at the last minute rule change, that creates more work for insurers already scrambling to get shoppers signed up.
"It seems like this is another effort to put more of the onus on insurers," the insurance official said.