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Reform Update: State exchanges plan extensions for consumers thwarted by tech woes


By Paul Demko
Posted: March 19, 2014 - 3:00 pm ET
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Several state-based health insurance exchanges that have experienced technological problems are planning to extend enrollment beyond March 31. But only those who have started the enrollment process by the deadline will be eligible for extensions.

Maryland, Massachusetts, Nevada, Oregon, Vermont and Washington all plan to allow individuals who have encountered problems while trying to sign up for coverage to complete the process after March 31.

HHS Secretary Kathleen Sebelius has suggested that the federal exchange, which is handling enrollments in the 36 states that opted not to set up their own online marketplace, will establish a similar plan for consumers who have been thwarted by technological problems.

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States are taking a variety of approaches to make sure that everyone who wants to enroll in coverage is able to do so. In Massachusetts, more than 200,000 residents have been stymied in their efforts to enroll in plans that adhere to the coverage requirements of the Patient Protection and Affordable Care Act. The state previously received permission from the federal government to allow those individuals to either retain their current coverage or enroll in temporary plans through June. Massachusetts is now seeking an additional extension that would allow its residents to remain enrolled in those plans through the end of September.

On Tuesday, the board of Maryland's exchange adopted a plan (PDF) to allow individuals to finish enrolling after the deadline. State residents will need to call a hotline by March 31 and indicate that they've encountered problems. All callers will be contacted for enrollment assistance with coverage that will be effective May 1, a release from the board stated. All four health plans selling products on the exchange have agreed to participate.

Oregon is seeking a waiver from the federal government that would allow its open enrollment period to run through the end of April. But federal officials have repeatedly indicated that they don't have the authority to extend the deadline for individuals who have not sought to obtain coverage.

Officials in Washington state say they will weigh whether individuals are entitled to an enrollment extension on a case-by-case basis. In Vermont, exchange customers will simply have to indicate that they encountered problems with the state's website.

“We have the flexibility to get them the coverage that they need,” said Emily Yahr, public information officer for Vermont Health Connect. “They just need to tell us that they had trouble getting in and we'll honor that information.”

Several state-based health insurance exchanges that have experienced technological problems are planning to extend enrollment beyond March 31. But only those who have started the enrollment process by the deadline will be eligible for extensions.

The board of Nevada's health insurance exchange is considering a special enrollment period for applicants who attempted and failed to sign up before March 31.

For women, preventive services alone more costly than exchange plans

Uninsured women who pay out-of-pocket for recommended annual preventive healthcare services would end up spending more than they would for a bronze-level exchange-purchased insurance plan.

The average cost of a bronze health exchange plan is approximately $1,116 a year, and around $1,740 annually for a silver insurance plan. By comparison, estimated total costs for receiving annual preventive services without insurance is $1,231, according to an analysis conducted by personal finance data website NerdWallet.

The site compared the annual premiums of silver and bronze exchange plans reported by the HHS' Office of the Assistant Secretary for Planning and Evaluation for a 27-year-old woman earning $25,000 a year with average costs for healthcare services in five major cities—New York, Chicago, Los Angeles, Philadelphia and Houston. Health services included a well-woman visit, an HIV test and a cervical cancer screening, as well as the annual cost of taking oral contraceptives.

Follow Paul Demko on Twitter: @MHpdemko


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