All Counties in Federal ACA Marketplace Covered in 2015, Counihan Says

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By Sara Hansard

Oct. 15 — All counties in states covered by the federally facilitated ACA marketplace will have access to coverage in 2015, the director of the office in charge of implementing the law's insurance reforms said Oct. 15.

“Going into next year we will have no empty counties” in the federally facilitated marketplace (FFM), Kevin Counihan, marketplace chief executive officer and director of the Center for Consumer Information and Insurance Oversight (CCIIO), told attendees at the Health Insurance Exchanges Forum sponsored by America's Health Insurance Plans

Counihan said that on Oct. 14, the FFM began sending notices to current enrollees explaining the renewal process. To have coverage by Jan. 1, 2015, enrollment must be completed by Dec. 15, he said.

The second open enrollment period for Affordable Care Act coverage is scheduled to run from Nov. 15 through Feb. 15, 2015. “We're just entering the critical last stretch for open enrollment preparation,” he said. “We feel confident we're going to have a successful 2015.”


Consumers are being advised in the notices to access, the federal enrollment website, between Nov. 15 and Dec. 15 to update applications for income, family and eligibility information; compare plans; and get enrolled, Counihan said.

On Oct. 15, CCIIO released a five-step process to help consumers, brokers, assisters, call center personnel and others understand the renewal process, he said.

For the upcoming open enrollment period, the Centers for Medicare & Medicaid Services anticipates that “millions will enroll, re-enroll or be auto-re-enrolled,” Counihan said. The agency's goals for 2015 are “to maximize the enrollment of both returning and new customers,” ensure there are affordable products on the marketplaces, ensure that data and payments are accurate and timely and enhance the consumer experience, he said.

The FFM experienced major technological problems during the first open enrollment that made it difficult initially to enroll. For 2015, “CMS has deployed best practices and innovative approaches to ensure end-to-end testing, integrated functionality and overall readiness for both technology and business operations,” Counihan said.

Website Enhancements

The website and the “front-end consumer experience” are being enhanced; data improvements have been made; and the online federal Small Business Health Options Program (SHOP) marketplace is being built, Counihan said.

The online federal SHOP marketplace has been delayed a number of times as the administration has struggled to get the individual FFM operating smoothly.

For the individual FFM, “the site is designed to handle more consumers and deliver higher overall throughput with greater reliability,” Counihan said. Monitoring and alert capability has been added this year, “so that we'll know what's broken, why and where before users do,” he said.

In dealing with consumers, it is clear that “deadlines work,” Counihan said. Forty-seven percent of those who enrolled for 2014 during the first open enrollment period signed up during the last four weeks, particularly those in the 18-to-34 age span, he said.

About 7.3 million people enrolled and paid premiums in the ACA marketplaces for 2014. The Congressional Budget Office has estimated that a total of about 13 million people will be enrolled under the law in 2015.

Cost `Top Area for the Uninsured.'

“Cost is the top area for the uninsured,” Counihan said. Further, people need personal assistance from navigators, counselors, agents and brokers and others to choose the right plan, he said.

Counihan described the effort to get the uninsured enrolled under the ACA as “the bottom of the first of a nine-inning game.” Many ACA enrollees who are receiving premium subsidies will be filing tax returns for the first time in 2015, “so we're particularly sensitive to providing the support that they need in order to complete those filings,” he said.

“We may not be able to fix everything in the first year or right away, but we can figure out ways to implement those changes,” Counihan said.

Re-Enrollment `Brand New' for Marketplace

In a separate session Ben Walker, director of open enrollment at CCIIO, said FFM officials are focusing on the re-enrollment process for 2015, because “re-enrollment's a brand new thing for the marketplace.”

Marketplace open enrollment notices are going to everyone enrolled, as well as everyone determined to be eligible to enroll but who aren't, Walker said. People who applied in 2014 but were outside the open enrollment period can now enroll for 2015, he said.

Current enrollees will hear from issuers about the availability of their plans, any changes for the plans and 2015 premiums, Walker said. Where tax information is available, consumers will be notified about their eligibility for subsidies, he said.

If it appears that consumers' subsidy eligibility has changed from 2014, they will be encouraged to visit the marketplace and shop for plans, Walker said. People who don't take action will be automatically re-enrolled in the same plan they are in for 2014, he said.

After Dec. 15, changes can be made by consumers through Feb. 15, 2015, that will be effective after Jan. 1, Walker said.

To contact the reporter on this story: Sara Hansard in Washington at

To contact the editor responsible for this story: Janey Cohen at


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