TOPICS > Politics

Enrollment delay for health care law coverage raises concerns for insurers

November 22, 2013 at 12:00 AM EDT
The Obama administration announced changes to the health care law, pushing back the deadline to sign up for coverage. Due to the troubled rollout, people will now have until December 23 to enroll in a policy that begins in 2014. Jeffrey Brown gets details from Louise Radnofsky of The Wall Street Journal.

JUDY WOODRUFF: The Obama administration announced several changes today that they say will make it easier for Americans to sign up for insurance coverage under the new federal health care law.

Jeffrey Brown has the story.

JEFFREY BROWN: Some of the key changes involve timelines for enrollment.

First, consumers trying to get new coverage starting January 1 now have an extra week to finish enrolling. The new deadline to sign up is December 23. The administration also announced it will push back the start of next year’s enrollment period by one month. That effectively means that in year two of the program, Americans can start signing up in mid-November 2014.

And late this afternoon, officials announced another change for this year. Insurers will be able to directly enroll people in three states, Florida, Texas and Ohio.

Louise Radnofsky of The Wall Street Journal has been following these developments and is here to explain.

Welcome to you.

LOUISE RADNOFSKY, The Wall Street Journal: Thank you.

JEFFREY BROWN: So, if we start with the changes for this year, this one about pushing it back a week, what’s behind that?

LOUISE RADNOFSKY: Well, the main reason behind it, the administration says, is that people have had problems getting into the site and they haven’t had very much time to get their stuff together in time for January 1.

What the insurers are saying is that the extension for other people actually creates a more compressed time frame for them. They now only have a week to process some of these applications if it turns up on December 23.

JEFFREY BROWN: This is all, first of all, because of the pressures of the roll out, right, the problems, but also the expected, I don’t know, glut, perhaps at the end of the year.


And the administration says it’s working up stepping up the capacity for the site around the surge in December. But, of course, there are questions about whether the site can handle that and whether the carriers can handle it, too.

JEFFREY BROWN: And just to be clear for people, you still can sign up later to be covered later in 2014.


Typically, insurance starts on the first date of the month. So, if you want coverage for January, getting in by the December deadline is important and then so on.

JEFFREY BROWN: This was done, as you said, in consultation with the insurers? Is there differences in — well, what had to be worked out?

LOUISE RADNOFSKY: Well, the administration — the insurers say that they were told about it, but they didn’t think it was a good idea. They’re very concerned about it now and saying so pretty loudly, so the consultation appears to have been somewhat one-sided.

JEFFREY BROWN: Now, to deal with this expected influx at the end of the year, the administration came out today and they said that they actually feel a little bit better. What are they — what are they looking at?

LOUISE RADNOFSKY: Well, they’re looking at the same data that we’re looking at that seems to suggest that there is an uptick in interest in November both in the federally run and in the state-based exchanges too.

So, it suggests that more people were going through the site. That said, what the insurers are saying is that they’re having difficulty still with the data that is coming from people when they have completed the sign-up process. The more people that get through, the harder it is because they’re checking them manually in a lot of cases.

JEFFREY BROWN: But the technology — they feel a little bit better about the technology at this point?

LOUISE RADNOFSKY: They feel a little bit better for the technology, as you said, for the direct enrollment process, for the three states where the administration is testing this out now.

But that’s been something they wanted since the beginning, and it’s only just ready now.

JEFFREY BROWN: Now, what about this — this other announcement, that — the direct enrollment from insurers in three states? This is kind of a pilot program.


It’s where the insurer basically gets to help somebody sign up for a plan that they hope will be theirs in the end of it. There have been a lot of technical problems with making it work as intended. There has been some exploration of a work-around. It sounds as if it is just about working well enough now to test it out.

JEFFREY BROWN: So, how is it going to work, and why these three states?

LOUISE RADNOFSKY: These three states are the biggest ones, among the biggest ones that are having their exchanges run by the federal government because they chose not to do so. So, it seems like an obvious place to start.

It also seems as if plans in those states were able to persuade the administration that they were be willing to be the guinea pigs.

JEFFREY BROWN: And is it possible that then it would roll out — I mean, it would be allowed in other states?

LOUISE RADNOFSKY: That certainly seems to be the hope.

Again, the administration is struggling to get people signed up on its own. It needs all the help it can get.

JEFFREY BROWN: All right, and then there’s next year.


JEFFREY BROWN: Pushing it back another month. Now, why did the administration say it wanted to do it? And then we can get to the implications of that.

LOUISE RADNOFSKY: This is very different in terms of reasoning.

What the insurers have been saying is that they don’t think they’re going to have enough information from the first quarter of next year in order to set their rates around April for the 2015 cycle. They think that they might be uncertain partly because there have been a number of last-minute changes to the law about the state high-risk pools, with the administration’s decision to allow carriers to continue selling policies that would otherwise have been canceled.

And this disruption, they say, could lead to uncertainty. Generally, when insurers feel uncertain about something or their actuaries feel uncertain about something, they err on the side of caution, and caution in this case means higher rates, higher rates for 2015. You can see why that would have spooked people.

JEFFREY BROWN: But also, of course, it plays into the politics, right, because it immediately got criticized by skeptical Republicans.

LOUISE RADNOFSKY: It has certainly not been lost on people that this sidesteps the midterm election period of 2014. People will not be going through open enrollment while they’re also voting.

The Republicans were very quick to criticize that as…


JEFFREY BROWN: That would mean we wouldn’t know the number of people signed up and we wouldn’t know the rates in — by the time of the…



JEFFREY BROWN: … of the election.

LOUISE RADNOFSKY: We might actually know the rates. They tend to be available through various ways a little bit sooner, but they’re certainly not plastered up there and most people are not seeing them the way that reporters are seeing them.

JEFFREY BROWN: The White House response to the Republican criticism today?

LOUISE RADNOFSKY: Well, White House, the administration has just emphasized that it did this change, the open enrollment delay change, based on the needs of insurers. And certainly that is a very compelling reason for them to have done it, perhaps even beyond the politics, that they want to see the law work as they intended.

JEFFREY BROWN: All right, one other last thing, briefly, which is California this week decided that it wouldn’t pick up people who had lost their insurance because of the new ACA, bucking what President Obama himself had asked for.

LOUISE RADNOFSKY: What we’re seeing from California is a division among Democratic states about what to do.

The president’s move was designed to take political pressure off the law. What some supporters of the law, including these states, are saying is…


LOUISE RADNOFSKY: … that it could damage its actual prospects for success, and they’re preparing — they’re preparing to stay the course on it.

JEFFREY BROWN: So, some states are going along, some states are making a decision like California?

LOUISE RADNOFSKY: Yes. And among blue states, or states that are running their own exchanges, typically, what you’re seeing is states that have a well-working state exchange are more willing to require people to give up the policies than people — than states that don’t have this exchange available.

JEFFREY BROWN: Louise Radnofsky of The Wall Street Journal, thanks so much.