Insurers seek expanded role in reform enrollment

With a perfect fix of nowhere in sight, some insurers are pushing for a shortcut to help them enroll people in health plans directly by accessing a federal platform that determines subsidy eligibility, according to The New York Times.

The government may reject this idea based on concerns about protecting the privacy and security of citizens' personal data, including financial and tax information and immigration status. A more likely workaround is for insurers to estimate qualifications for subsidies with later verification of the estimates by the federal government, the Times noted.

But even this is an imperfect solution. While it may raise enrollment numbers, if actual subsidies are significantly lower than initial estimates, both insures and customers may be at financial risk, according to the article. 

The proposed shortcut is the latest in a series of workarounds by insurers and states to circumvent enrollment problems. States like Indiana, Wisconsin and Iowa are trying to help their residents avoid pitfalls by extending some existing insurance programs, building separate enrollment systems and implementing more protections for certain consumers, FierceHealthPayer previously reported. Insurers also are assisting with the repair.

Meanwhile, the Obama administration is expanding the definition of a health plan enrollee under the Affordable Care Act, The Washington Post reported.

Here's the difference: Insurers only count people as enrolled if they've made a premium payment. But  "enrollment" data to be released this week "will measure people who have filled out an application and selected a qualified health plan in the marketplace," an anonymous administration official told the Post. The Obama administration will use this widened enrollee definition because that's where a customer's interaction with ends, the administration official said, stressing that the government isn't responsible for collecting insurance premium payments.

Arguments about actual enrollment numbers may fuel political fighting over the Affordable Care Act, the Post noted. Each side may choose different enrollment counts to support positions for or against the efficacy of healthcare reform.

For more:
- read the New York Times report
- read the Washington Post article