CMS officials have yet to say if the agency will implement an open-enrollment extension for people facing tax penalties who don't have coverage, an extension several states also are considering after Washington state enacted one.
Some Congressional Democrats have been urging the Obama administration to implement a special-enrollment period for tax filers facing penalties. Sen. Tammy Baldwin (D-Wis.) and 10 other senators who caucus with the Democrats, on Monday sent a letter to HHS Secretary Sylvia Mathews Burwell calling for additional time to sign up for coverage.
“We are confident that this special enrollment period would build on the success of the law by allowing even more uninsured Americans to benefit from the health and financial security provided by the Affordable Care Act,” they wrote.
Limited extensions have been granted on the federal exchange and in several states to allow individuals who hadn't completed the application process to get signed up for coverage. The enrollment extension for the 37 states that use the federal government's exchange site is limited. Open enrollment through the state and federal health exchanges officially came to a close Sunday.
People who called the HHS call center Feb. 13-15 but were unable to complete the process because of long wait times can still enroll through Feb. 22. Consumers who encountered technical glitches on HealthCare.gov in the final days are also eligible for the extended enrollment period.
Insurers are prepared to handle consumer demand during the extensions, several said.
Health Care Service Corp., the Blue Cross and Blue Shield plan for Illinois, Montana, New Mexico, Oklahoma and Texas, expected the increased activity at the end of the open-enrollment period, spokeswoman Lauren Perlstein said in an e-mail. The company plans to continue its expanded outreach, such as keeping its call center open 24 hours, this week.
Health insurer Medica, which operates in Minnesota, North Dakota, South Dakota and Wisconsin, said it supports the extension for those who were trying to obtain health insurance at the last minute. “We are certainly referring members to the exchanges if they believe they are impacted,” said Dannette Coleman, Medica's senior vice president for individual and family business.
Massachusetts extended its health plan enrollment deadline to Feb. 23 largely because the area has experienced inclement winter weather. But for health coverage to go into effect March 1, state residents will have to pay their first premium by Feb. 23.
Maryland and New York are allowing exchange customers who were in the process of enrolling through the end of the month to complete the process. Hawaii residents will have 45 days beyond the deadline to finish enrolling.
Even if states haven't extended the enrollment window, there may still be opportunities for individuals to sign up for 2015 coverage directly with insurers. Private health insurance exchange eHealth has identified 28 states —including California, Florida and Texas—where at least one insurer is accepting enrollments through Feb. 23 or beyond. However, individuals who sign up directly with health plans can't access federal subsidies, which are available to households with incomes up to 400% of the federal poverty level.
The most significant extension occurred in Washington state, which operates its own exchange. The Washington Health Benefit Exchange extended open enrollment by two months to April 17.
For many consumers, this open-enrollment period was the first they heard about the ACA's tax penalties for not having health coverage. The penalty for 2014 was $95 or 1% of income, whichever was greater. That rises to $325 a person or 2% of income for 2015. Washington officials said they wanted to lengthen health plan enrollment into tax filing season so more people could be aware of the potential fines when they file next year.
Washington also experienced technological problems with its exchange site during the first portion of this year's open enrollment.
“We didn't want to open up multiple special enrollment periods,” said Richard Onizuka, CEO of the Washington Health Benefit Exchange. “We just wanted to make sure we provided the opportunity for consumers to enroll if they wanted to enroll.”
Because this was the first re-enrollment sign-up and many people may be distracted during the holidays, an extension was a good idea, said Melanie Coons, a spokeswoman for Premera Blue Cross and LifeWise, separate insurers that sell policies on Washington's exchange.
“It's really important to get as many people covered as possible,” Coons said.
CMS officials have indicated that they are open to a similar extension to accommodate Americans facing tax penalties for the 37 states relying on HealthCare.gov. “CMS has not announced any final decision regarding a tax-related special enrollment period for consumers,” agency spokesman Aaron Albright said in an e-mail. “If and when a decision is made, we will notify consumers and stakeholders immediately.”
Other state-based exchanges also are considering an open-enrollment period to target tax filers. “We are looking into that possibility,” said Jenni Bowring-McDonough, media relations coordinator for Minnesota's exchange. “Nothing's been decided.”
Kathleen Tallarita, a spokeswoman for Access Health CT, expressed a similar sentiment. “We are evaluating the process and expect to announce our decision in the very near future,” she said in an e-mail.
Jason Lefferts, director of communications for Massachusetts Health Connector, said it's unlikely that the state will implement a special-enrollment period for tax season since residents have been assessed tax penalties since 2008. “We've had the individual mandate here for a number of years already,” he said. “This wouldn't be a new experience for people to find out that they need health insurance.”
America's Health Insurance Plans, the trade group representing health plans, took a somewhat positive but narrow view toward the HHS extension. While an extension gives consumers additional time to find a plan, AHIP supports a “very, very defined scope for that enrollment window,” spokeswoman Clare Krusing said. Health insurers have encouraged tight sign-up timelines to avoid people getting health insurance only when they need it, which could skew the risk pool toward sicker members.
Extensions also have to take into account that health plans are building qualified health plans for 2016, Krusing said.
Longer term, some have suggested shifting the entire schedule of the ACA's exchange enrollment. Low-income consumers may be more inclined to buy health insurance during tax season since tax refunds provide more disposable income than the gift-intensive holiday season, a Health Affairs study found last year.
Some also think moving the dates of open enrollment could eliminate any confusion with Medicare's annual enrollment window, which occurs at the end of the calendar year. Ken Fasola, CEO of private health insurance exchange HealthMarkets, said the overlap of the two enrollments has created some stress. “There's only so many telephone and field resources available,” he said.
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