When the Obama administration launched the Healthcare.gov website on October 1, the president and his officials focused on the coverage that would now be available to the uninsured as of January 1, 2014. However, with the recent flood of cancellations of those who were told they could "keep their plan," millions more will need new insurance in place by the beginning of the new year. The well publicized "glitches" have slowed enrollment considerably, and now there is new evidence that consumers will find themselves with even less time to secure coverage than originally thought.
An editorial in last week’s USA Today repeats the common belief about the deadline: "The deadline for signing up for insurance that begins Jan. 1 is Dec. 15." However, "signing up" for insurance is not enough. As the Healthcare.gov website states [emphasis added]:
If you enroll in a private health insurance plan any time between October 1, 2013 and December 15, 2013 and make your first premium payment, your new health coverage starts January 1, 2014.
Kathleen Sebelius echoed this requirement in a Wednesday conference call:
Payment is not due until Dec. 15 for January coverage, Sebelius said.
"By the 15th of December, we'll be able to tell you how many people have actually paid for the first month of coverage," she said.
However, paying the premium is not necessarily a simple matter. An online chat with a Healthcare.gov representative revealed that the site is not recommending using the exchange to make the initial premium payment. The representative was not even completely sure the option was being offered. Here is an excerpt from the chat [emphasis added]:
Healthcare.gov Representative: To have coverage effective January 1, 2014, you must make your first premium payment by December 15, 2013. Your health insurance company can tell you how to make your premium payment. If you do not make a payment on December 21, 2013, you may have to fill out another application.
TWS: I can't make a payment through healthcare.gov?
Rep: It may give you that option when you complete your enrollment.
TWS: If I don't pick a plan until 12/15, won't it be too late for my info to go to the insurance company, them to bill me, and me to make a payment by 12/21? Seems pretty tight.
Rep: You must make your first premium payment by 12/15/13 for your coverage to begin January 1, 2014. If you make your payment by the 21st, your coverage will begin in February 1, 2014.
TWS: You said above "It may give you that option" to pay on healthcare.gov. Does that mean it's not available yet?
Rep: We are still experiencing some technical difficulties with the website, which is why it would be best to possibly go through the insurance company to make your first premium payment.
The federal government run exchange is not the only one to experience problems with premium payments. The Maryland Health Connection, that state's version of the Obamacare exchange, announced a week ago Friday that it was suspending the bill-pay feature indefinitely:
Accepting payment is not required of a state-based marketplace, and the Board approved deferring this option until after the core items are addressed. The ACA requires insurance carriers to be ready to accept the first payment from consumers, and our carriers are prepared to bill and receive the first payment from our enrollees.
In addition, just last Friday, Maryland announced that individuals should enroll early to allow time for billing and payment:
For coverage effective by January 1, 2014, individuals are encouraged to enroll before December 10 to allow time for premium invoicing and payment processing with their insurance carrier.
Since information regarding plans, premiums, and possibly subsidies must pass from the exchanges to the insurance companies before the consumer can be billed, someone who waits until December 15 to enroll seems unlikely to secure coverage by January 1. The mid-December deadline therefore would appear to be optimistic, and in reality probably falls earlier in the month, very close to the November 30 target date for the Healthcare.gov website to be fixed. The window of opportunity for consumers needing coverage for 2014 for all practical purposes may be about a week.