Residents in States With Troubled Exchanges Can Still Get Subsidies

From California Health Line, February 28, 2014

On Thursday, the Obama administration announced that residents in states that experienced technical problems with their state-run health insurance exchange websites still will be able to receive federal subsidies even if they purchase coverage outside of the exchange, the AP/Sacramento Bee reports.

According to the AP/Bee, the change is significant because up until Thursday, the subsidies were only available to consumers who purchased health insurance through the Affordable Care Act's exchanges.

In announcing the policy change, HHS said, "We recognize that some states have experienced difficulties in processing automated eligibility determinations and enrollments." Therefore, the administration is "providing options to marketplaces to ensure eligible consumers have access to financial assistance and issuers are paid," the department said.

The change will allow eligible residents to obtain the subsidies retroactively.

However, the AP/Bee notes that it might be difficult for states and insurers to implement the change because it is "couched in technical jargon." For example, consumers must demonstrate that they tried to enroll for coverage through their state's exchange, and the health plan they purchased outside the exchanges must meet certain ACA requirements.

Officials in some of the states that have been dealing with a myriad of technical issues in their exchanges welcomed the policy change. Oregon Gov. John Kitzhaber (D) -- whose state's exchange did not launch until this month because of various issues -- said the policy "means that many more Oregonians will be able to access better coverage at a more affordable cost" (Alonso-Zaldivar,AP/Sacramento Bee, 2/28).

CMS Continues To Fix HealthCare.gov

Meanwhile, CMS on Thursday said it is continuing to work to resolve several lingering issues with HealthCare.gov, The Hill's "Healthwatch" reports.

Officials said the agency has made the account creation process easier, added additional support at different points of the application and enrollment process and created ways for consumers to report life changes that might impact their eligibility status.

In addition, CMS Communications Director Julie Bataille -- in a "Digital Strategy" blog post -- said the agency has worked to improve the website's customer service by providing staff with additional training and hiring more staff members who speak Spanish.

Bataille also wrote that HealthCare.gov's technology staff "continues to monitor system performance in real time, 24/7 and take steps to improve the user experience" (Viebeck [1], "Healthwatch," The Hill, 2/27).

TIME Report Says Obama Considered Shuttering HealthCare.gov, Starting From Scratch

CMS' announcement came within hours of publication of a new TIME Magazine investigative piece, which reported that President Obama considered pulling the problem-plagued federal health insurance exchange website offline following its launch in October 2013 to rebuild it from scratch, "Healthwatch" reports.

Account to reporter Steven Brill, Obama sent White House Chief of Staff Dennis McDonough to CMS in October 2013 to gauge whether the website could be repaired. McDonough told Brill that Obama "wanted to know if [the site was] salvageable," or if it needed "to be scrapped to start over."

In his article, Brill highlights the challenges of fixing the site and the team of experts that the administration gathered -- who worked almost round-the-clock for about six weeks -- to complete the repairs. In addition, the article details a series of events led by federal contractors, CMS and other parts of the administration that lead to site's early failures (Viebeck [2], "Healthwatch," The Hill, 2/27).

According to Brill, one unidentified White House senior adviser said meetings surrounding the site "drove [Obama] crazy" because "[n]obody could even tell us it the system was up as we were sitting there, except by taking out laptops and trying to go on it." On Oct. 17, 2013, Obama proposed shutting down the site and rebuilding it from scratch (Brill, TIME Magazine, 3/10).

The administration did not respond to requests for comments on Brill's piece, "Healthwatch" reports (Viebeck [2], "Healthwatch," The Hill, 2/27).

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