Those who couldn't sign up for Obamacare by the deadline because of technical glitches with the health care website may get a lifeline, Health and Human Services Secretary Kathleen Sebelius announced Thursday. But the administration is going to need buy-in from the insurance industry.
People whose applications have been hampered by the ongoing technical failings of both HealthCare.gov and also 30 states' federally run exchanges may be granted retroactive enrollment if the problems prevent them from meeting the Dec. 23 deadline for Jan. 1 coverage, according to HHS. Sebelius and other officials laid out measures the federal government is taking to prevent consumers from experiencing a gap in their health coverage during Thursday's conference call with reporters.
HealthCare.gov has shown signs of improvement since the beginning of December, and enrollment in private health insurance and Medicaid began to tick upward last month. But time is running out for individuals who want to be certain that they won't be uninsured next month. Enrollments in both private and public benefits continue to be threatened by numerous problems, including health insurance companies and state governments receiving inaccurate data from federal computer systems about their would-be enrollees.
Providing extra help to people frustrated by the health insurance exchange website could protect more individuals against huge medical costs if they become sick or injured next month and only then learn that the coverage they believed they selected wasn't actually in place. HHS also will consider further extending the deadline for January coverage, which originally was Dec. 15, and now is Dec. 23.
"The steps we're taking today will help ensure that Americans seeking quality, affordable health coverage can do so with even more peace of mind and with even more confidence that it will be there when they want and need it," Sebelius said.
In addition to granting special dispensation for some consumers, Sebelius outlined other actions the administration is taking in hopes of smoothing the transition to 2014 -- all of which would require the cooperation of health insurance companies that may be reluctant to go along.
The administration wants insurers to effectively backdate coverage for consumers who either miss the Dec. 23 deadline to enroll or the Dec. 31 deadline to pay their first premium, or make only a partial payment, said Michael Hash, the director of the department's Office of Health Reform. Insurance companies also are asked to pay for prescription refills that were covered under new customers' previous policies, as well as visits to medical providers who aren't in their networks, including in cases when the provider lists on HealthCare.gov turn out to be inaccurate.
"We're encouraging them to offer retroactive coverage," Hash said. "Our partners in the insurance world are really wanting to work with their prospective and newly enrolled individuals to make sure that ongoing medical care that they may be involved in is seamless."
Shifting responsibility to health insurance plans in order to reduce the disruption caused by problems with the Obamacare rollout is reminiscent of Obama's request that state regulators and insurers allow consumers to renew policies that were being canceled because they don't meet the Affordable Care Act's benefit standards. The insurance industry and state officials reacted coolly to the proposal, and only a portion of those plans will be made available next year.
"Many issuers today do retroactive coverage in the current market and we continue to want to work with them, and do believe that many of the plans will be interested in making sure that people who pay after are able to be enrolled on time," said Chiquita Brooks-Lasure, the policy director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services. Aetna already has agreed to accept customers' first premium payment as late as Jan. 8, she said.
Earlier Thursday, the Centers for Medicare and Medicaid Services announced a one-month extension of coverage for people enrolled in the Pre-Existing Condition Insurance Plan, a program for people whose ailments or medical histories led private companies to refuse them coverage. That program was set to expire on Dec. 31.
Some Democratic lawmakers have suggested that the March 31 deadline for 2014 coverage also be extended, but Sebelius and other administration officials have said so far they won't be granting an extension.