As we all know too well, the fight over passage of President Obama's Patient Protection and Affordable Care Act (ACA) dominated the news for nearly two years.
Sadly, little public attention is being paid to the regulatory decisions being made right now by the Department of Health and Human Services that could determine whether President Obama's signature achievement can meet its promise of enrolling every American in a qualified health plan.
These regulations will directly impact exactly how and where more than 18 million uninsured Americans (37 percent of the 50 million uninsured), whose incomes are between 133 percent and 400 percent of the poverty level, for whom the ACA provides premium subsidies, can purchase insurance.
Specifically, they will determine whether these low income Americans -- a disproportionate number of whom are black and Hispanic -- will be allowed to use the same enrollment tools that are available to higher income individuals. At question is whether the states will be allowed to give individuals who qualify for premium subsidies the option of enrolling through private Internet marketplaces as well as through their newly created exchanges.
The answer may very well determine whether the act will have the capacity to enroll all of the insured. These private marketplaces have developed state of the art technology and enrolled millions of people, a high percentage of who were previously uninsured. Furthermore, private marketplaces are more likely than government entities to foster new technologies that will continue to help all consumers.
Paradoxically, the ACA specifically permits individuals with incomes more than 400 percent over the poverty level to buy insurance through a state exchange or a private marketplace.
It is ambiguous as to whether lower income individuals who qualify for premium subsidies may receive the subsidies if they enroll in qualified health plans through an entity outside a state exchange. That means low income people in need of a subsidy may not be able to enroll in a qualified plan through a private marketplace.
Left uncorrected, that glitch in the law could deny low-income people the same tools for enrollment that the health care law offers more affluent people. Sophisticated technology expands the reach of this program and that ought to be our aim.
That's why governors from both parties, the chairman and the dean of the Congressional Black Caucus, and the League of United Latin American Citizens (LULAC), among others, have urged HHS Secretary Kathleen Sebelius to issue regulations that allow states the option of using private Internet marketplaces to supplement their exchanges for the purpose of enrolling individuals eligible for tax subsidies in qualified health plans -- as long as those private marketplaces provide access to the same plans with the same benefits and part of the same risk pool as are on state exchanges.
Before my current role, I was the founder of a non-profit organization called One Economy that learned the value of utilizing technology with enrollment and outreach for low-income individuals. Every year we signed up thousands of Americans in vital programs, such as the Earned Income Tax Credit and the Children's Health Insurance Program. We learned that without fully harnessing the power and reach of technology the result is likely the unintended consequence of creating additional disparities for the poor.
President Obama has long supported public-private partnerships to achieve desirable public ends. This is a perfect example of such a circumstance.
The bottom line is that technology enabled innovation applied to health care can go a long way toward reducing our national problem of health outcomes and healthcare disparities. Let's get the regulations right and make America healthier.
Rey Ramsey is the President and CEO of TechNet, the leading network of high tech CEOs and senior executives.