Troubled exchanges seek more time
Amid problems ranging from the minor to the extreme, at least half a dozen state exchanges are offering enrollment extensions of sorts, but only one is pushing federal limits and trying to extend open enrollment.
While the feds have been insistent that they legally can't continue open enrollment at Healthcare.gov or at state exchanges beyond March 31, exchanges in Maryland, Massachusetts, Nevada, Oregon, Vermont and Washington State are giving consumers extra time through a range of options -- all of them except Oregon falling short of seeking an actual open enrollment extension.
Washington State's Healthplanfinder exchange is making case-by-case basis determinations for people who've already started applying, and Nevada Health Link and Vermont Health Connect are doing likewise albeit on a broader scale, with Nevada giving applicants another 60 days and Vermont promising to accommodate anyone who's tried to apply.
Massachusetts has secured federal approval to extend coverage until the end of June for Bay Staters who were previously insured through the state's pre-Affordable Care Act subsidized plans, while would-be newly insured consumers who've tried unsuccessfully to enroll through the dysfunctional Massachusetts Connector are being temporarily covered by Medicaid. The state is seeking to extend that transitional policy through the fall.
In Maryland, where the Maryland Health Connection board is considering suing the since-terminated IT contractor for damages, consumers who can't enroll online before March 31 can call a hotline, let exchange staffers "know that they have started an application but have been unable to complete it" and receive "special assistance" to enroll in coverage starting May 1.
All four of the exchange's insurers -- CareFirst BlueCross Blue Shield, Evergreen Health Cooperative, Kaiser Permanente and UnitedHealthcare -- are on board with the idea, and like most of the other states' plans, it deftly avoids the conundrum of trying to actually extend the open enrollment period.
But in Oregon, where the Cover Oregon exchange has experienced perhaps the worst of all HIX debacles, limiting consumers primarily to paper applications, Gov. John Kitzhaber's administration is asking the Department of Health and Human Services for a waiver to extend open enrollment through the end of April -- a request that promises to test the bounds of federal health reform law and the HHS Secretary's power to triage reform programs.
The clock is of course ticking on that request, and it comes as Oregonians are learning more about what exactly went wrong with the development on an exchange that in the months leading up to October 2013 was promoted with great enthusiasm, including multi-million commercials featuring local musicians.
On March 20, Kitzhaber released an independent review of the exchange that found, among other problems, a lack of adequate oversight for the lead IT contractor and an unskeptical faith among government leaders the project would ultimately come through. The report prompted the resignation of Bruce Goldberg, MD, Oregon Health Authority director and interim Cover Oregon director, along with other management changes.
Kitzhaber, meanwhile, is still hoping for the enrollment extension waiver. In a media release, he said he recently spoke with HHS Secretary Kathleen Sebelius and that "All options are being explored." An announcement on the future of exchange will come the week of March 24, he said.
