By Melissa Attias, CQ Roll Call
October 23, 2015 -- Consumers in 38 states will have the ability beginning Sunday to window shop for health coverage on the federal marketplace website, which will include a new feature to estimate their total out-of-pocket costs.
But federal officials aren't guaranteeing that new tools will be ready so consumers can easily search for plans on healthcare.gov that cover their doctors and prescription drugs when the third open enrollment period begins Nov. 1.
Lori Lodes, communications director for the Centers for Medicare and Medicaid Services (CMS), said federal officials currently have a little over half of the data validated from insurance companies for these website tools to work, and they "need that to be better." She cited complications from drugs being listed multiple times and doctors having multiple offices.
"We want to make sure that we are getting consumers the best experience and have the right information," Lodes told reporters at a briefing. "When we're confident in the data, the information that they're getting, that's when we're going to release it."
She also noted that consumers will still be able to go to the insurer's provider directory to find that information without having the new feature in place. When it's ready, she said, the information will be built into the healthcare.gov platform rather than having to go to a third-party source.
CMS Acting Administrator Andy Slavitt, appearing via webcam at the briefing, said that officials have continued to improve the site for the third open enrollment period based on consumer feedback. He said the response time on the website will be 40 percent faster this year and that healthcare.gov is monitoring health plan websites daily so it has the latest information about providers.
"As issues arise, as they inevitably will, we will as we have in the past work through them, keeping consumers our primary focus," Slavitt said.
The third open enrollment period for the insurance exchanges set up through the Affordable Care Act runs from Nov. 1 until Jan. 31. Slavitt said the focus will be on retaining current customers, boosting new enrollment and improving the experience for consumers.
New Features
Kevin Counihan, CEO of the health insurance marketplaces at CMS, touted the new out-of-pocket cost calculator as a "key tool to really help educate people on the plans that they're picking." The feature provides users with an estimate of premiums, co-pays and deductibles after they select whether they expect low, medium or high utilization of health services for each individual on the plan.
"They're going to make better choices, they're going to have fewer surprises, fewer calls to the call center—a better user experience," Counihan said.
Officials said the new calculator and the provider and prescription drug lookup tools will warn consumers that the features are new. The site will recommend that consumers call their providers and health plans to confirm the information.
Lodes also said the updated website will tailor information to whether an individual is a returning customer or signing up for the first time, citing past confusion because information focused on first-time applicants.
Consumers who return to the site to re-enroll will no longer have to enter a 14-digit identification code, she said, because the site will have the plan automatically saved for them.
Another feature will present individuals with a screen outlining how much financial help they qualify for and other eligibility information as soon as they complete an application. Under the old system, about 1 in 4 people who applied for coverage did not click on the PDF file that showed those details, Lodes noted.
Healthcare.gov also will remind individuals to re-enter their Social Security number if the system has trouble matching their data, as officials found some people weren't entering that information or were keying it in incorrectly.
Counihan said CMS cut the number of internal system errors generated during normal processing by 50 percent compared to last year. The agency also replaced the back end of the system that consumers use to create accounts and log in, which he said will make the site faster and more stable so that more visitors can be on the site at the same time.