ACA’s Second Enrollment Period Closes; Deadlines Widely Extended

On February 17, HHS Secretary Sebelius announced that 11.4 million people signed up or re-enrolled through state and federal Marketplaces after the final and largest traffic surge on healthcare.gov. HHS’ announcement of a one-week special enrollment period for individuals who experienced technical difficulties applying came after the IRS income verification function experienced a glitch over the weekend, causing a site outage on Healthcare.gov for several hours, according to USA Today. Ten State-based Marketplaces have also extended their enrollment deadlines, including Washington State and Minnesota, which instituted extensions into April in consideration of those who become aware when they file taxes of the penalty for being uninsured.

Marketplace Coverage Will End in February for 200,000 People with Unresolved Citizenship/Immigration Status

Approximately 200,000 people who have not confirmed their citizenship and immigration status for their 2014 Marketplace coverage are receiving notice that their coverage will terminate at the end of February, according to CMS. The Agency said it has conducted several outreach attempts to reconcile the individuals' missing documentation and confirm their citizenship or immigration status to no avail. While for most applicants citizenship and immigration status is matched against federal databases, if the information in the database is insufficient, applicants must provide documentation to verify their status within 90 days of request. Some advocates argue that failure to respond may be due to the complexity of the federal requests for documentation, as well as to technical difficulties transferring and storing the submitted documentation. Last year, 112,000 people lost coverage under similar circumstances.

Cost-Sharing Reductions Provide Savings for Lowest Income Enrollees in the Federal Marketplace, According to New Study

new brief describing average cost-sharing reductions for low-income enrollees in silver health plans on the Federally-Facilitated Marketplace finds that individuals in the lowest income tier (150% FPL and under) receiving the maximum cost-sharing assistance save an average $2,300 on annual deductibles, paying $229 compared with $2,559 for a silver plan with no cost-sharing reductions. Similarly, the Kaiser Family Foundation report finds that the average out-of-pocket limit for individuals receiving maximum cost sharing assistance is $879 compared to $5,824 for standard silver plan (saving nearly $5,000 on average). The authors note that individuals who receive this assistance are at risk of losing their cost-sharing reductions, along with tax credits, as the legality of the subsidies on the Federal Marketplace is being tried in the King v. Burwell Supreme Court case.

GAO Report Identifies 32 High Risk Areas, Citing Healthcare.gov as IT Example

In its biennial update on federal operations with high vulnerabilities to fraud, waste, abuse, and mismanagement, or that are in need of transformation to address economy, efficiency, or effectiveness challenges, the Government Accountability Office (GAO) identified two new high risk areas since its 2013 report, including “Improving the Management of Information Technology (IT) Acquisitions and Operations.” Healthcare.gov was called out as an example of an IT initiative with room for improvement, and GAO says it will issue the results of an ongoing review of the website early this year. Medicare, Medicaid, and improper payments by both were all listed as high risk areas, as they were in 2013. The study cites the size and scope of both Medicare and Medicaid as challenges, and identifies the need for CMS to work with states to identify and collect improper Medicaid payments as enrollment increases and more Medicaid beneficiaries receive services under managed care and/or private insurance through the implementation of the ACA.