PPACA open enrollment period enters home stretch

March 04, 2014 at 08:38 AM
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(Bloomberg) – The federal government will be using appeals from President Obama and his wife, Michelle, to try to get uninsured consumers to sign up for coverage by the March 31 public exchange plan enrollment deadline.

The government also is going to warn consumers about the new fines that will face some consumers who go without health coverage. Up until now, the government has left information about the new individual "shared responsibility" fines out of most Patient Protection and Affordable Care Act (PPACA) program advertising.

PPACA requires many individuals to get "minimum essential coverage" (MEC). Some individuals who fail to buy "MEC" may have to pay tax penalties equal to 1 percent of their taxable income.

Consumers can avoid having to pay the penalties by getting coverage from employers, government programs, traditional individual health insurers, commercial insurance sales websites, or the new PPACA public exchange prrograms.

Consumers who qualify for Medicaid or other government aid programs can apply for those programs at any time of the year.

Many consumers will "get MEC" by buying private "qualified health plan" (QHP) through the new PPACA public exchanges. The QHP open enrollment period started Oct. 1 and is now set to end March 31.

Some consumers will be able to buy QHP coverage after March 31 because they go through major life changes, such as a marriage or the loss of a job, or because they qualify for hardship exemptions. The U.S. Department of Health and Human Services (HHS) has extended many other PPACA deadlines and might find a way to extend the individual QHP enrollment deadline.

For now, however, individual QHP market rules require consumers to buy coverage by March 31 or else wait until 2015 to get MEC.

About 4 million Americans have so far signed up for QHP coverage, and about 3.5 million more have enrolled in Medicaid, according to Avalere Health, a consulting firm.

The administration's success signing up more people in the last month of enrollment will have repercussions for insurers, which must set rates for 2015 by the end of May, and in congressional elections this November.

"We're not going to be happy until we reach the overwhelming majority of people who've been uninsured," Ron Pollack, the executive director of Families USA, a consumer advocacy group allied with the White House, said in a phone interview. "There still continues to be a lack of information among a large portion of the uninsured about the new benefits that are available to them."

The government has had particular trouble signing up Latinos and administration officials said Obama will focus on that community this month. He is scheduled to participate in a "town hall" event March 6 hosted by groups focusing on Latino enrollment, including the California Endowment and large Hispanic media organizations such as Univision and Telemundo, according to a statement today that the White House asked be attributed to a senior administration official.

Only about 20 percent of Californians who have enrolled through the Covered California exchange are Latino, for example, even though they comprise about 57 percent of California's uninsured population. They are important to PPACA's success because of their growing political clout and because Latinos tend to be younger and healthier than uninsured Americans in general.

HHS held enrollment events directed at Latino audiences in Dallas, Philadelphia, Chicago, Atlanta and Tampa, Florida, last week, and HHS Secretary Kathleen Sebelius plans to travel to Houston and Phoenix this week to encourage people to sign up.

Outreach effort

"Outreach is occurring in every state in the nation with a particular emphasis on areas with the highest population of the uninsured, using a mix of grassroots activities and engaging with officials from the state, local, and community level and other groups to raise awareness, as well as television, radio, and digital advertising," Joanne Peters, a spokeswoman for Sebelius' agency, said in an e-mail.

PPACA, seeks to provide access to health plans for the country's estimated 48 million uninsured. The Congressional Budget Office projects that 6 million high-income and moderate-income people will sign up for QHPS through the public exchanges by the March 31 enrollment deadline.

While U.S. officials are trying to develop advertising that will make more clear the penalty Americans face if they don't carry insurance, Pollack said the government's outreach should focus on financial assistance available to help pay insurance premiums. People with incomes from one to four times the poverty level — as much as $94,000 for a family of four — are eligible for discounted premiums on insurance exchanges.

"The most important piece of information that needs to be conveyed relates to the very large subsidies people can receive that will make all the difference in the world in making insurance affordable," he said. "That needs be accentuated even further. There are still huge numbers of uninsured people who are unaware of these subsidies."

–With assistance from Alison Vekshin in San Francisco. Editors: Andrew Pollack, Bruce Rule.

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