HHS Expands Direct Obamacare Enrollment: Will Insurers Respond?


People signing up for health insurance next year can buy subsidized insurance without having to visit HealthCare.gov, the federal health insurance marketplace, the CMS announced recently.

The move could be an early sign the Trump administration will take a backseat to the private sector in getting Americans to sign up for health insurance, policy analysts told me recently. If the federal government isn't active about encouraging enrollment, analysts warn, fewer people will purchase insurance.

“If the federal government steps back, it could have a real impact on the numbers,” Sarah Lueck, a senior policy analyst for the Center on Budget and Policy Priorities, told me.

But, there’s another scenario where the federal government advertises open enrollment and continues outreach to areas with pockets of uninsured while insurers and web brokers, those privately run insurance comparison sites, also focus attention on the individual health market. In this future, enrollment may grow, Jeffrey Sachs, principal of the Sachs Policy Group, a consulting firm in New York City that specializes in federal and state health policy, told me.

Direct enrollment, when consumers sign up for health insurance directly with the companies selling plans, presents an opportunity for insurers with great websites to capture a larger share of the individual market, Sachs said. People signing up for insurance won't be directed to HealthCare.gov, where they can see a host of health plans, he said, reducing the risk they'll purchase a competitor's product.

However, this also means consumers will have less opportunity to compare plans, Sachs said.

“While the user experience may be better, some people using third-party sites (even those not owned by insurers) will have reduced enrollment options presented to them,” he said. “They may not be aware of the full range of options, like plans that are less expensive or have networks that fit them better.”

Since President Donald Trump took office with a promise to repeal the Affordable Care Act, advocates for Obama-era health policy have worried the federal government will spend less money and dedicate less manpower to encourage Americans to sign up for health insurance.

Sign-up efforts were a major part of President Barack Obama's health agenda, but the Trump administration has demonstrated they aren't a high priority. Trump undercut the individual mandate by allowing Americans to avoid saying if they have insurance coverage on their tax forms and cutting funding for enrollment advertising.

The Centers for Medicare & Medicaid Services May 15 announced a plan to roll back the public health insurance marketplace for small businesses by allowing companies to work directly with insurers.

Together, these policy changes indicate an interest by the Department of Health and Human Services to leave future open enrollment largely up to the private sector.

Under the Obama administration, direct enrollment was meant to complement, not replace, HealthCare.gov. This would ensure Americans could purchase subsidized insurance by comparing all federally qualified health plans available to them in the place they can trust.

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