January 28, 2014 – February 3, 2014

Updates

  • Round two of coverage starts: Coverage began February 1 for consumers who enrolled between December 25, 2013 and January 15, 2014. The deadline for March 1 coverage is February 15, and open enrollment continues through March.

Top Successes

  • HealthCare.gov technical improvements
    • Medicaid handoffs: The Centers for Medicare and Medicaid Services (CMS) can now transfer information about individuals who were assessed eligible for Medicaid by Healthcare.gov to states electronically so that states can determine eligibility and complete the enrollment process. Previously, CMS transferred this information via flat files, which contain minimal information on enrollees. Some states have the capability to receive these electronic files, while others will continue to receive information through flat files.
    • Immigrant identity verification: CMS has recently identified why many immigrants may be having problems with the identity verification process when applying for coverage through HealthCare.gov.
      • The issue: The name identification function for this population is sensitive to case, spaces, and punctuation, like hyphens and apostrophes.
      • Suggested workaround: Enter the name entirely in uppercase and remove all spaces and punctuation. So far, this workaround has been reported as successful.
  • Enrollment assisters assisting each other: Assisters in Illinois, New York and Pennsylvania are coming together to share tips on tricky scenarios and technical workarounds to get all interested consumers enrolled.
  • State-based marketplaces fix errors
    • Colorado: Connect for Health Colorado moved 300 of its consumers into Medicaid after the state discovered these individuals received inaccurate eligibility determinations. It appears that these consumers had been determined ineligible for Medicaid using 2013 eligibility levels and not been appropriately screened using the expanded 2014 Medicaid eligibility levels. The result was that these consumers ended up enrolling in marketplace plans starting on January 1, 2014 instead of Medicaid.
    • Maryland: A new state law allows consumers who have been unsuccessful in enrolling through Maryland Health Connection to get retroactive coverage through the state’s high risk pool until they are able to get other coverage. The state expects a few hundred individuals to use this option.

Consumer Experiences in the Field

  • Consumer issues: Enroll America’s field staff report that the most common problems consumers encountered last week was affordability for individuals who fall into the Medicaid gap and general application/website troubles.

Challenges

  • Enrollment assisters uncertain about consumer follow-up: Reports from enrollment assisters indicate that many wish to follow up with consumers after they have helped them enroll in coverage to provide additional information on how to maintain their health coverage and use their health insurance, but are not doing so because of confusion surrounding rules on how to handle personally identifiable information (PII) – phone numbers, names, email addresses, etc. After confusion in October, CMS issued a sample consent form that would allow assisters to follow up with clients if they could not complete the enrollment process during their appointment. However, enrollment assisters are unsure if this consent form also allows them to follow up after the enrollment process has been completed. Stakeholders are urging HHS to provide clarification to enrollment assisters about whether they can retain PII in order to follow up after their clients are enrolled.
  • Connecticut backlog: Anthem Blue Cross Shield, the largest marketplace insurer in Connecticut, with more than 25,000 enrollees, has experienced a backlog in processing payments and providing identification cards, making it difficult for consumers to prove coverage when seeking care. The state has been working closely with the insurer to expedite processes and has taken steps to ameliorate the burden on consumers by extending payment deadlines and sharing reimbursement forms.
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