direct enrollment could send numbers soaring


The Centers for Medicare & Medicaid Services has fixed the malfunctioning direct enrollment process on, thereby allowing insurers to directly enroll consumers into plans they're selling on the federal health insurance exchange.

Consumers can go directly to an insurer's website to learn about their exchange plans, where they would then get referred to to determine whether they're eligible for federal subsidies. Then consumers would be directed back to the insurer to purchase a plan, CNN reported.

Although the direct enrollment option isn't new, CMS had to fix some technical issues with consumers' subsidies not transferring back to the insurer's website.

Despite the fix, some insurance industry sources remain skeptical, primarily because the repair effort hasn't yet proven itself. Indeed, CMS Communications Director Julie Bataille said insurers should still test the technical fixes against their own systems before using the direct enrollment process, reported Politico.

Plus, many insurers were hoping CMS would create a "back door" portal to the like so many state exchanges provide. That would mean consumers don't have to actually interface with the cumbersome federal website.

Consumer advocates are worried about the direct enrollment option because it undermines the goals of maximizing consumer choice and facilitating plan competition. Timothy Jost, a consumer advocate and professor at Washington and Lee University, noted that direct enrollment likely "will allow insurers that dominate certain markets to retain, perhaps even extend, their dominance," he wrote in a blog post for the journal Health Affairs.

But he also conceded the enrollment option could help more consumers obtain health coverage. "If direct enrollment can be made to function properly, it is likely that we will see a surge of direct enrollments between now and the end of the year, and on through the open enrollment period," Jost said. In particular, he added, insurers that have canceled individual policies could guide affected consumers to 2014 plans through direct enrollment.

To learn more:
- read the Politico article
- see the Health Affairs blog
- check out the CNN article

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