ACA Headaches Continue

Delays, technical glitches, political squabbling and frustration from consumers and agents alike have colored the implementation of the Affordable Care Act (ACA), particularly over the last few months. Tensions surrounding the launch of what was to be a major overhaul of the health insurance system in the United States has reached such levels that even some of the law’s most ardent advocates have come out in support of delaying or tweaking provisions of the ACA.

As predicted by critics, open enrollment on Oct. 1 for the ACA’s new online Marketplaces was a political and logistical disaster. Millions of consumers who visited www.healthcare.gov on its launch date were greeted by error messages and found themselves unable to sign up for coverage.

The White House said some glitches in the system were expected and promised they to overcome them with time, but fell short of taking full responsibility for the messy launch and slew of problems that continue.

Agents operating in the small group markets were particularly disappointed with the rollout of the Federally-Facilitated Marketplaces (FFMs), where the U.S. Department of Health and Human Services (HHS) is either fully or partially running the online Marketplaces in 36 states. Less than a week out from open enrollment, HHS announced the online enrollment and plan pricing for small businesses had been delayed until at least Nov. 1. At press time, the program was still suffering serious complications.

In the middle of the recent government shutdown, HHS also quietly announced that the issuer-based method of enrollment for agents to use in the individual market in the FFMs was not operational. HHS also failed to provide an estimate as to when it would be corrected. In the individual market FFMs, agents were supposed to have two different methods of enrollment: using the Marketplace website itself to work with a consumer on enrollment, or the issuer-based method using the insurance company’s website. In the small group (more popularly referred to as SHOP) FFMs, agents may only use the Marketplace website for enrollment, so this particular delay is not an issue.

Many experts worry that the problems with the government websites, while serious, are only the tip of the iceberg. Also of grave concern is that 2014 is the launch year for not only the online Marketplaces, but also the individual mandate, which bars insurers from considering pre-existing conditions and many other coverage expansions. The success of the law depends on enticing as many young and healthy individuals into the risk pool as possible to keep “price shock” from setting in, which would cause rates to spiral out of control. The end result of the interplay between the law’s many complex provisions was already uncertain, and the website woes only increase the chances of future problems.

As the rollout of the ACA continues and the Administration scrambles to put out an ever-growing number of fires, only time will tell if the law functions as its authors and supporters envisioned.

Margarita Tapia is Big “I” director of public affairs.