As technical problems with the government’s new health insurance marketplace slow the pace of sign-up, a variety of “fixes” have been proposed. But some of these would create their own challenges. In rough order from least to most disruptive, here are some of the ideas:
1) Fix the website on schedule
This is everyone’s favorite idea. The Obama administration says it hopes to have HealthCare.gov working smoothly for most users by the end of November, though it’s not clear that target will be met.
2) Use alternative government sign-up paths
A 1-800 number and enrollment by mail can save would-be customers hours in front of a frozen computer screen. But ultimately, all the enrollments have to be processed through the same computer system.
3) Direct sign-up with insurance companies
Customers can use HealthCare.gov or commercial websites to shop for coverage without a lengthy enrollment process, then contact insurers directly to sign up for coverage. For now at least, though, people who use this option will not be able to take advantage of government subsidies.
4) Extend enrollment window / delay individual mandate
If timely enrollment is not possible, there will be pressure to extend various deadlines, beyond mid-December for coverage that begins in January and beyond late March to avoid a penalty. Without the pressure of these deadlines, though, younger, healthier people may wait longer to sign up, leaving a sicker, costlier pool of patients covered and potentially driving up premiums.
5) Preserve nongrandfathered, nonconforming private plans
Lawmakers are considering options to codify the president’s promise that people who like their old health insurance can keep it, even if those plans don’t meet the minimum standards set by the Affordable Care Act and aren’t already grandfathered in. Experts cite several potential problems with that: Those policies don’t include the consumer protections of the health care law, and by siphoning off healthy customers (who were generally the only ones who qualified for coverage under the old system), this would also skew the pool covered on the exchanges, raising prices for everyone else.
6) Something else?
The White House has promised its own plan to help those whose policies have been canceled and who have not yet been able to sign up for new coverage. There’s no word yet on what that plan might include, but spokesman Jay Carney says it will be announced sooner rather than later.