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Simplified Forms Could Speed Health Law Enrollment This Fall

By Rebecca Adams, CQ HealthBeat Associate Editor

October 8, 2014 -- Administration officials recently showed off a simplified application for new enrollees to sign up in health law marketplaces that cuts the number of computer screens users fill in from 76 to as little as 16.

The federal website should be able to handle significantly more traffic than last year, officials said. People will be able to enroll on their mobile phones. And the revamped site's ability to transfer enrollment information to health insurers is in final testing before the next open enrollment period, which begins on Nov. 15.

While serious technical problems plagued the launch of a year ago, this year's challenges may be more focused on signing up more consumers, keeping people enrolled and helping customers make the best choices for themselves from among an increased number of plans.

Administration officials have an "obsessive focus on consumers," Centers for Medicare and Medicaid Services Principal Deputy Administrator Andy Slavitt told reporters. Slavitt, who as a federal contractor won praise for helping to fix the flawed website, and CMS Marketplace Chief Executive Officer Kevin Counihan, who ran Connecticut's well-regarded health insurance marketplace, were brought in this summer to ensure that this year's experience goes smoother than the website's troubled debut.

"We didn't bring you here today to show you this today and say we've got the whole world solved," Slavitt told reporters, after a demonstration of the simplified application for first-time users. People who face complex situations will still have to use the original application, which is also online. The website will automatically adjust the application process based on consumers' responses to a set of questions that are asked early in the online enrollment process.

"This is going to be a continuously improving set of capabilities" for consumers, said Slavitt.

The simplified application is available now. People can sign up for coverage before the official open enrollment period starts on Nov. 15 if their personal circumstances–such as employment, access to health insurance, marital status, the number of people in a family and residency–have changed since the last enrollment period ended in April. About 20,000 people have already used the forms, said Slavitt, and roughly 70 percent of those signing up for the first time will be able to use them.

The simplified process isn't available to people who got a marketplace plan last year, and a major concern for administration officials is making sure that people remain happy with coverage and stay enrolled. Those who are renewing coverage can fill out an electronic form with some–but not all–of their information already entered in computer fields. One challenge is that people who want to maintain their existing arrangements will need a 14-character identifying number for the insurance, which is available through plan documents or by calling a federally-funded call center. If a consumer doesn't have the code, the individual also could re-select the plan from the options listed on the website.

Another hurdle is encouraging people who have a plan to shop around and make sure that they are still getting the best deal available for them. The insurance premiums and other costs may have gone up, or a patient's doctor may no longer be in a plan's network.

CMS will send notifications to enrollees to urge them to re-evaluate their options, said Counihan. The administration also will work with agents or brokers who advise customers. A larger number of workers at call centers also will be available to help people enroll.

Consumers will need to make changes to their accounts by the 15th day of each month in order for the changes to take effect on the first day of the following month.

Returning customers who don't take any steps to change coverage will have their plan automatically renewed on Jan. 1. They will get the same subsidy that they received last year, but the costs of coverage may change. People should update their financial information to make sure they're getting the right subsidy, say consumer groups and administration officials.

As of Aug. 15, about 7.3 million people had paid their premiums to get coverage. The Congressional Budget Office projected that a total of 13 million returning and new customers will be enrolled for the full year in 2015.

Enrolling that many people and making sure they are pleased with the coverage could be difficult. The administration also is still months away from automating programs to send payments to insurers, including money for the subsidies that most consumers get to discount their coverage.

Still, administration officials seem pleased that the technical problems are expected to be less difficult for consumers than last year. Instead of the approximately 10 days of testing before last year's Oct. 1 open enrollment start, federal officials started almost six weeks of complete end-to-end testing yesterday.

Slavitt said the administration is in a "very different spot from last year when we were building from whole cloth."

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