The Obama administration is promising a smoother and more user-friendly shopping experience on HealthCare.gov when the 2016 enrollment season for marketplace health coverage begins on Nov. 1.
But a new feature that lets online users see which doctors and hospitals are covered by certain health plans will not be ready on Day One. Neither will a similar search tool that shows which prescription medications each plan will cover.
Tests on both new features are well underway, and officials at the Department of Health and Human Services are encouraged by the results. But insurers have provided HHS with only half of the information that consumers need to make educated coverage decisions.
Having learned from the premature launch of HealthCare.gov in October 2013, HHS officials won’t unveil the new “doctor lookup” and “prescription drug lookup” features until they’re sure the information and technology are solid.
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“One of the key lessons learned is we don’t want to introduce anything that’s not fully working,” said Kevin Counihan, CEO of the federal marketplace at HealthCare.gov, which serves consumers in 38 states.
10.5 million The number of uninsured Americans eligible for marketplace coverage. About half are young adults between ages 18 and 34.
In a video meeting with reporters on Friday, Andy Slavitt, acting administrator for HHS’ Centers for Medicare & Medicaid Services, said he was “very confident” that the insurers’ data would be fully provided.
But Lori Lodes, the centers’ communications director, wouldn’t promise that the features would be working by the time enrollment ends on Jan. 31, 2016. “Coming soon” was all Lodes would say.
“In an ideal world, we would have gotten 100 percent of the data and have it validated and we would be ready to go right this second,” Lodes said at a press briefing Friday at HHS headquarters. “But we have a little over half of the data validated. . . . We don’t want to put this tool out there before we have more data from the issuers that’s been validated.”
HHS urges plan members to call their insurers to make sure that their plans include the doctors, hospitals and medications they prefer.
Anticipation for the marketplace enrollment season is already building. Phone calls to HealthCare.gov call centers are up 25 percent this week and web traffic is up 10 percent, officials said.
The Affordable Care Act requires that most Americans get health insurance for 2016 or pay the higher fine of either 2.5 percent of annual household income or $695 per uninsured person. The penalty is $347.50 per uninsured child under age 18.
About 40 percent of the remaining uninsured who qualify for marketplace coverage are low- to moderate-income workers, earning about $30,000 to $60,000 for a family of four. About half have less than $100 in savings and nearly 60 percent don’t know about or how to access the tax credits that can help them pay for marketplace insurance.
As officials prepare for the third open enrollment at HealthCare.gov, Counihan said the site’s response time will be 40 percent faster this season after eliminating unnecessary hardware from the system.
“We’re going to get better, faster and cheaper every year,” Counihan said.
Pages were redesigned and directions were improved to streamline page navigation.
Returning customers will be able to find their current health plan more easily and see whether it’s available next year. They’ll also be able to comparison shop against other health plans without entering a 14-digit identification number, Counihan said.
Consumers will be able to see immediately what kind of coverage they qualify for, how much financial assistance is available to them and whether they need to provide more information during the application process. New prompts will encourage people to enter their Social Security number or immigration information if they forget to do so.
And a new calculator that estimates plan members’ out-of-pocket coverage costs – premiums, deductibles and co-pays – based on their personal information has also been added to the window shopping tool.