Private Marketplaces to Offer Direct Enrollment in ACA Plans Soon, CMS Says

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By Alex Ruoff  

Nov. 19 --Private online marketplaces and insurers may soon offer the same federally subsidized health plans available on the federal health insurance marketplace website, a Centers for Medicare & Medicaid Services spokesman said on a call with reporters Nov. 19.

Nearly 40 private insurance marketplace companies signed agreements with the CMS earlier this year to offer direct enrollment in qualified health plans but have since been stymied by technical problems with HealthCare.gov.

Contractors working to improve the federal health insurance market completed “the majority of high-priority fixes for direct enrollment” this week, CMS spokesman Julie Bataille said. The agency expects these private companies, known as web brokers, to begin offering enrollment in qualified health plans soon, she said.

The announcement came on the same day lawmakers urged the Department of Health and Human Services to expand the ways consumers can enroll in insurance plans to boost enrollment numbers.

Sens. Ben Cardin (D-Md.) and Barbara A. Mikulski (D-Md.) sent a joint letter to HHS Secretary Kathleen Sebelius Nov. 19 saying glitches in the federal marketplace were preventing some individuals from enrolling.

“We are concerned that while the website's troubles remain unresolved, healthy individuals will abandon attempts to apply online, and we want to ensure that they can learn about plans and apply for coverage,” Cardin and Mikulski wrote. “Further, if and when additional glitches in the web site arise, Americans should have additional easy-to-navigate avenues to apply for coverage.”

The lawmakers said the HHS should “streamline the paper application form and dedicate additional resources to help uninsured people evaluate their plan options and select coverage.”

Private Marketplaces

The CMS issued guidance in May for entities wishing to offer direct enrollment in qualified plans.

A provision of the Affordable Care Act, Section 1411, provides the HHS the necessary flexibility to allow direct enrollment with health insurance companies, while allowing applicants to remain eligible for subsidies if applicable, according to Cardin and Mikulski's letter.

The federal marketplace repairs that made direct enrollment possible were improvements to data management systems and federal subsidy determination tools, Bataille said.

Nate Purpura, a spokesman for eHealth, the company that operates eHealthInsurance.com, told BNA Nov. 14 that his company has been working since October to create an electronic interface capable of exchanging plan information with the federal marketplace. He said the ongoing repairs had complicated that effort but the company was making progress.

eHealth is one of the oldest and largest private online health insurance marketplaces.

The electronic interface, according to the CMS guidance issued in May, will allow consumers to shop for insurance plans on a private site, then connect to the federal marketplace to determine their eligibility for federal subsidies and then return to the private site to purchase a plan.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bna.com


The Cardin-Mikulski letter is at http://op.bna.com/mdw.nsf/r?Open=plon-9dltr7.