Murkowski calls for exchange plan gap fix

Sen. Lisa Murkowski, R-Alaska (Senator's office photo) Sen. Lisa Murkowski, R-Alaska (Senator's office photo)

What if some consumers going through health policy cancellations have trouble navigating the new system well enough to have replacement coverage in place Jan. 1?

Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, declined today to talk about measures CMS or its parent, the U.S. Department of Health and Human Services, might take if ongoing problems with the HealthCare.gov exchange enrollment systems continue to hamper consumers' ability to buy subsidized coverage.

"They would have time before Jan. 1" to enroll in coverage, Tavenner said at a hearing on the exchange program organized by the Senate Health, Education, Labor and Pensions Committee.

The Patient Protection and Affordable Care Act requires health insurers to make all individual major medical insurance sold either on or off the public exchanges, from now until March 31, on a guaranteed-issue basis. The only personal health status the insurers can use when setting individual coverage prices will be age.

To qualify for new PPACA tax credit subsidies, moderate-income consumers must buy coverage through the PPACA exchange system. To guarantee that coverage will be in place Jan. 1, consumers must sign up for coverage by Dec. 15.

Sen. Lisa Murkowski, R-Alaska, told Tavenner that her understanding is that the Alaska exchange, which is run by HHS, had succeeded at enrolling just three state residents in coverage as of Monday, and that there was a concern that those three residents had received inaccurate subsidy information.

Tavenner said consumers will have until March 31 to take advantage of the PPACA open enrollment period and avoid having to worry about the PPACA penalty to be imposed on the uninsured. In 2014, the penalty will be $95, or 1 percent of income, whichever is greater.

Murkowski said that, for Alaska residents who are losing existing coverage, possibly in part because of changes in laws and regulations created by PPACA, coverage gaps are a major concern.

"Consumers are saying, 'What if something happens to me in that first week in January,'" Murkowski said. "'If I fall through the cracks, am I going to be taken care of?'"

Also during the hearing:

  • Tavenner said CMS will start to put out exchange activity figures by the end of next week. At the hearing, she gave the same activity figure — that CMS believes state and federal exchanges have received a total of about 700,000 applications — that CMS has been giving for more than a week.
  • Sen. Christopher Murphy, D-Conn., noted that Connecticut — which has had a relatively smoothly functioning exchange enrollment site — has already met about 10 percent of its exchange plan enrollment target, and that the Massachusetts exchange program met only 0.3 percent of its enrollment target in its first month of operation. Of federal exchange coverage, he said, "I have confidence that this product will fly off the shelves once people can get into this website."

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