How to improve enrollment for 2015


Only one day after enrollment for the health insurance exchanges unofficially ended at midnight Monday, healthcare advocacy group Families USA outlined 10 ways to improve the exchange enrollment process next year.

Although about 9.5 million people have gained coverage through healthcare reform's Medicaid expansion, health insurance exchanges and private plans, Families USA said tens of millions of consumers remain uninsured. To help those people gain health coverage, the group looked at the first enrollment period for valuable lessons learned.

"Our recommendations build on the laudatory success of the first enrollment period," Families USA Executive Director Ron Pollack said yesterday in a statement. "If they are acted on well before the start of the next enrollment period, the momentum from that success will be sustained and significantly strengthened."

The suggestions insurers likely support include:

  • increasing the number of and resources for navigators;
  • building a substantial public campaign educating consumers about subsidies;
  • coordinating enrollment with the tax-filing season to boost professional tax preparers' role in assisting consumers;
  • streamlining Medicaid enrollment for consumers who participate in other federal and/or state programs; and
  • boosting coordination between Medicaid and exchanges to prevent applications from getting lost or delayed.

But some of the recommendations could place additional burdens on insurers, such as:

  • banning insurers from imposing premium surcharges on members who smoke;
  • requiring insurers to offer low-deductible silver plans that include routine care on the exchanges; and
  • excluding insurers from exchanges if they set "unacceptably high" premiums.

"These recommendations can make a huge difference in reaching the tens of millions of Americans who are still uninsured," said report co-author Rachel Klein, who is Families USA's enrollment program director.

Previously-uninsured people comprised a small share of total marketplace enrollees in February and the uninsured who didn't buy insurance on the exchanges cited perceived unaffordability as most common reason for not doing so, according to March survey results from the consulting firm McKinsey & Company and The Urban Institute.

To learn more:
- read the Families USA statement and report (.pdf)

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