January 14, 2014 – January 20, 2014

Notable updates

  • Pre-existing Condition Insurance Plans (PCIP) extended through open enrollment: The PCIP program covers individuals with pre-existing health conditions and was supposed to sunset on December 31, 2013 but will now continue through the end of March for those in the program who have not yet enrolled in new coverage. This extension was made to ensure these high-risk individuals do not have breaks in coverage while backend enrollment issues persist.

Top Successes

  • Consumer-facing side of HealthCare.gov continues to improve: The Centers for Medicare and Medicaid Services (CMS) reports that HealthCare.gov’s error rate and response times are down (0.5% and 0.5 seconds, respectively) and that the site successfully managed 1.8 million visits in one day, including 80,000 concurrent visitors. They are still focused on improving the online experience and fixing stubborn issues.
  • Federally facilitated marketplace (FFM) tips and workarounds: New resources for immigrants, tips for enrolling, and workarounds allowing consumers to work directly with insurers to update contact information, fix name spelling errors, and add dependents to their plans are helping move many consumers stuck in the application process towards coverage. The workarounds are temporary solutions as CMS works on permanent fixes to these issues.

Consumer Experiences in the Field

  • Consumer issues: Enroll America’s field staff reports that the most frequent issues consumers had this past week was confusion and technical trouble with the application process, including issues like the inability to log in and uncertainty about reporting income. Other issues were reported regarding HealthCare.gov’s failure to transmit enrollee information to state Medicaid departments, affordability, language access, and provider networks. We continue to share these issues with federal policymakers and relay updates and workarounds to the field.

Challenges

  • Medicaid handoffs: Reports from the field and partners continue to come in regarding the inability of HealthCare.gov to transfer applicants deemed Medicaid-eligible to their state agencies, which has led to a lot of confusion for consumers who have applied but have not been contacted about next steps and difficulty for those seeking health care. In many states, the best way for these consumers to get into their state’s system is to re-apply directly with their state. Minnesota is also having issues with Medicaid-eligible applicants not getting through their system.
  • State-based marketplace (SBM) call centers: Many SBMs’ call centers have excessive wait times (for example, California’s average wait time is 49 minutes) and are unable to answer basic questions, like how an individual would appeal an eligibility determination.
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