New Marketplaces Rules Should Make It Easier to Get Covered and Stay Covered in 2017 and Beyond

By Zachary Baron and Molly Warren

With unprecedented demand and millions signing up for coverage during the third open enrollment period (OE3), the enrollment community already has much to celebrate as we head into 2016. And as Enroll America gets ready to build on this initial progress in order to finish OE3 strong, we’re also keeping our eyes on the horizon for how to maximize enrollment through year-round outreach and in future open enrollment periods.

One way policymakers can support Enroll America and our partners’ efforts, and reach our shared goal of maximizing enrollment, is by adopting smart consumer-friendly changes that streamline the enrollment process. In November, the Centers for Medicare and Medicaid Services (CMS) released far-reaching proposed regulations concerning the marketplaces, in-person assisters, and health plans. As part of Enroll America’s commitment to improving the consumer experience, we offered recommendations for policymakers to ensure that every consumer is best positioned to get covered and stay covered.

Our comments on this regulation focus on several important issues — here’s a quick run-down of six of them:

  • In-Person Assistance: Expanding post-enrollment duties for Navigators can help boost health insurance literacy and better prepare consumers for the tax filing moment. This further reinforces the need for CMS to increase Navigator funding, strengthen training materials, and increase programmatic and information technology support.
  • Enrollment Opportunities: As we’ve previously highlighted, greater alignment between enrollment and tax filing (through a tax filing Special Enrollment Period [SEP] and adjusting open enrollment dates) can further elevate financial help and capitalize on the real impact of the fine to motivate uninsured consumers to take action. As CMS considers ways to improve the existing SEP process, it should expand data-driven strategies to broaden the pool of eligible consumers signing up through SEPs.
  • Renewal Process: Active re-enrollment remains the best strategy for consumers to make sure they stay covered in the right plan that fits their needs and budget. But if CMS adopts an alternative re-enrollment hierarchy for those who don’t take action, it must provide adequate notice for consumers and, in addition to premiums and metal level, consider other important factors that influence consumers’ enrollment decisions, such as cost-sharing, benefits, and provider networks.
  • Financial Support for Outreach and Marketing: While time- and resource-intensive, Enroll America has seen firsthand the significant impact of repeated follow-up to drive consumers to take action (especially young people, African Americans, and Latinos). With research showing substantial gaps in knowledge among the remaining uninsured, we urge CMS to finalize its user-fee structure to expand the amount of financial resources dedicated towards outreach and marketing.
  • Web Brokers: Web brokers play an important role in the overall enrollment effort. We encourage CMS to find the appropriate balance between oversight to ensure proper consumer protections and flexibility that allows web brokers to provide innovative, consumer-friendly enrollment experiences.
  • Standardized Plans: Finding the right plan is often a challenge for consumers. We support CMS’ goal of helping consumers identify plans that meet their needs and budget by instituting a standardized option in the FFM, including the requirement for first-dollar coverage for certain services.

This is just a brief overview — you can read our full comments on these topics and more here. We look forward to CMS finalizing these regulations so that even more consumers can sign up for and maintain comprehensive coverage in the years ahead.

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