Technology That Could Simplify Exchange Enrollment Process Will Not Be Ready for Open Enrollment Period, Reports AIS Newsletter

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Technology designed to determine federal subsidy eligibility will not be ready in time for open enrollment on Nov. 15, industry observers tell Inside Health Insurance Exchanges.

Technology designed to allow insurance carriers and web-broker entities (WBEs) to determine federal subsidy eligibility and directly enroll consumers on exchange plans through their own websites will not be ready for the coming open enrollment period which starts Nov. 15, according to reporting in the Oct. 2 issue of Atlantic Information Services’s Inside Health Insurance Exchanges (HEX). The interface, Eligibility Verification as a Service (EVaaS), would seamlessly connect to HealthCare.gov to determine subsidy eligibility without redirecting the consumer to the federal portal. Because it’s not ready, subsidy-eligible consumers will only be able to enroll in exchanges via government-supported sites like HealthCare.gov, or the state-run marketplaces.

Had EVaaS had been available last year, consumers could have enrolled in coverage through websites operated by carriers and WBEs, decreasing reliance on the glitchy federal website. And while EVaaS enjoys broad support from government and the health insurance industry, its implementation hasn’t been high-priority. CMS’s Center for Consumer Information and Insurance Oversight (CCIIO) “didn’t have the time or resources to make it work because they were focused on HealthCare.gov,” says Joel Ario, the first director of CCIIO’s Office of Health Insurance Exchanges, and now managing director at Manatt Health Solutions. CMS instead worked on updating HealthCare.gov for the second open enrollment season, with the agency saying that 70% of consumers will have access to a shorter and simpler application. This streamlined application, however, will not be available to carriers and WBEs.

The challenge now is to get EVaaS in place for 2016. “There is a compelling rationale to give consumers multiple entry points, not just one public portal,” Ario says. Despite some opposition from people who see government-run exchanges as the first step to a single-payer system, Ario is confident EVaaS will be implemented. “But like many parts of the [Affordable Care Act],” he says, “the IT challenge has so far impeded implementation.”

Visit http://aishealth.com/archive/nhex100214-01 to read the article in its entirety.

About Inside Health Insurance Exchanges
Inside Health Insurance Exchanges provides hard-hitting news and strategies on public and private health insurance exchanges, written for business leaders with health plans, pharma companies, hospitals and health systems, brokers and agents, and exchange managers and vendors. The newsletter delivers reliable intelligence on this critical cornerstone of health reform — the players and their partners, product designs and enrollment results, employer perspectives and much more. Visit http://aishealth.com/marketplace/inside-health-insurance-exchanges for more information.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

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