The next enrollment period for the Affordable Care Act (ACA) is now open and health insurance marketplaces are once again taking applications. A greater number of marketplaces have launched without major glitches this time, following efforts by both state and federal governments to improve the underlying technology between open enrollment periods. Still, several marketplaces are still facing glitches and getting more people to enroll during this round will be tough.
On the technology front, Obama Administration officials say that Healthcare.gov is stable and working well. Health and Human Services Secretary Burwell has a goal of enrolling approximately 2 million people during this open enrollment period. If 2 million enroll, that would bring the total enrollment figure up to 9 million. CBO numbers had 13 million enrolled as the projected figure by 2015 – a tall order.
CivSource previously reported on the variety of technology problems impacting Healthcare.gov as well as state exchanges. For states dealing with major glitches like Vermont which took its marketplace entirely offline, or Oregon which was forced to move to a paper based process last year, improvements are ongoing. Oregon and Nevada have abandoned their state exchanges totally in favor of using a federally run exchange, and are relying on navigators to help individuals sign up. Vermont and Massachusetts are now working with Optum to rebuild broken exchanges after scaling back relationships with CGI Federal.
Local press in Washington State reported that Washington Healthplanfinder, the state’s exchange was off and on throughout the weekend as traffic spiked with the new enrollment period.
The role of navigators is likely to increase this round as more of the unenrolled will need high touch help to complete the sign-up process. This is in part due to technology issues, but reports have shown that issues ranging from income verification to language and immigration status are also creating hurdles for individuals. Navigators effectively take individuals through the enrollment process using the buddy system. They answer questions and can help with language issues.
Navigators have emerged as a brigade of helpers that not only handle insurance sign ups but can also ensure individuals get to their appointments and follow ups. Research from Accenture has shown that vulnerable populations have been able to achieve better health outcomes when working with navigators. The fact that it requires a small army of specialists that speak both insurance and clinician-ese in order to help otherwise capable people navigate their way to a doctor is of course, a separate issue. Healthcare observers will also be watching to see how pricing holds over the next year, some have forecasted an increase in both premiums and out of pocket costs for individuals while others are expecting costs to stay flat to slightly lower.