Health-Insurance Deadline Extended in Late Push to Boost Numbers

From Wall Street Journal:

In a last-minute push to boost lagging enrollment in the health-insurance marketplaces, federal officials on Monday extended the deadline by 24 hours for people to sign up for coverage starting Jan. 1.

The deadline was originally set for midnight on Monday, but changes made over the weekend to the federal HealthCare.gov website will allow users to sign up for the first wave of coverage through Tuesday, people familiar with the matter said.

Insurers said they received no warning about the deadline change and hadn't prepared for it. Blue Cross & Blue Shield of North Carolina wasn't informed of the delay until Monday, and had already planned to close its offices and call centers Tuesday, said Michelle Douglas, a company spokeswoman.

Federal officials on Monday confirmed the move. The site had a surge of more than 850,000 visits by midafternoon, federal officials said. Continued bottlenecks in the federal website serving customers in 36 states prompted officials to delay the deadline, the people familiar with the matter said.

The change, made with no official announcement, is the latest in a string of policy shifts meant to help consumers who were stymied by website glitches or whose existing plans were canceled because they didn't comply with the law. But the changes also have led to confusion among consumers, taken insurers off-guard and compressed an already-tight timeline for the industry to put coverage in place by Jan. 1.

"Anticipating high demand, which we are currently experiencing, and the fact that consumers may be enrolling from multiple time zones, we have taken steps to make sure that those who tried to enroll today but had delays due to high traffic have a fail-safe," said Julie Bataille, director of communications for the Centers for Medicare and Medicaid Services.

 

Technical troubles with HealthCare.gov and state-run exchanges since the Oct. 1 launch have restricted consumer turnout: Only about 365,000 people signed up for private plans nationwide through November. While President Barack Obama said Friday that more than one million additional people enrolled in December, the total still falls far short of the 3.5 million originally projected to sign up by the end of the year.

 

The District of Columbia and 14 other states that are running their own marketplaces have set different deadlines. California's deadline was Dec. 23. But Peter Lee, executive director of the state's marketplace, said Covered California "will help people get to the finish line" if they started the process by Monday.

 

Oregon had earlier delayed its sign-up deadline for Jan. 1 coverage to Dec. 27. Minnesota is giving consumers until New Year's Eve to choose coverage starting the next day.

 

The extra day of enrollment in states using HealthCare.gov could leave open a window for young customers—desirable to insurers because they help offset the costs of older enrollees—who waited until the last minute to sign up, said Jim O'Connor, a health-insurance actuary for Milliman Inc.

 

Taken together, the late policy shifts compound "a lot of uncertainties" for a market that already anticipated broad change, said Heather Thiltgen, vice president of Medical Mutual of Ohio. While manageable, the latest change further compresses the time window for enrollees to pay for their plans, and for insurers to send out membership cards, she said.

 

"It could be a bumpy experience for those who enrolled late in the game," said Jeff Tikkanen, president of retail markets at Health Care Service Corp., which owns Blues plans in Illinois, Texas and other states.

 

Once HCS has a customer in the system, it will send a bill to a consumer, Mr. Tikkanen said. After payment is received, HCS can mail out an insurance card within 24 to 48 hours.

 

But that assumes each enrollment proceeds smoothly—and many have not, he said. Despite improvements, about 30% of enrollment files that Mr. Tikkanen's Blue Cross companies have received in recent days still contain errors, such as listing multiple spouses or listing dates of birth that occur on the "40th" day of a month. Each error must be manually corrected.

 

Aetna Inc., which was also unaware of the deadline shift until Monday, continued to see errors in its enrollment files as well, said spokesman Matt Wiggin.

 

 Administration officials have said they reduced error rates from about 30% to 10% by the end of November.

 Across the nation, insurers have only just begun the bureaucratic push to complete enrollments by reconciling data and collecting initial payments. Insurers have received first-month payments from about 35% of signed-up members, said Paul Tiede, an executive vice president at SunGard, which works with more than 200 insurers on software problems, including billing issues.

 

Some consumers may be unaware of the payment deadlines, he said. Insurers agreed last week to accept payments for coverage beginning Jan. 1 as late as Jan. 10, an unusual practice for an industry that typically requires customers to pay before their policies begin.

 

Blue Cross Blue Shield of Tennessee has pushed back its deadline even later, allowing payments by Jan. 15 for coverage effective Jan. 1. Consumers would have to pay out of pocket for services rendered before they pay their first premium, however, and submit requests for reimbursement later, said Gary Tanner, a spokesman.

Monday was a busy day, insurance brokers said. "Call volume was 10 times more than we expected," said Michael Mahoney, senior vice president of consumer marketing at GoHealth LLC, an Internet-based insurance broker that is one of a handful of third-party companies that has direct access to the federal system.

Wanda Geddie was among the last-minute shoppers Monday. She said it took about an hour to lock into a plan with Blue Cross & Blue Shield of North Carolina that will cost her around $47.50 a month, after factoring in federal subsidies. The site froze only briefly as she enrolled, she said.

 

Uninsured for the past four years, Ms. Geddie, 60 years old, said she planned to schedule an appointment with a specialist to treat her enlarged heart.

 

"It's been a while since I really went to the doctor. And at my age, I need to," said Ms. Geddie, a part-time mental-health worker from Fayetteville, N.C.