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 U.S. officials laid out a series of steps to help prevent
disruptions in coverage for health policies due to start Jan. 1,
including the possibility of retroactive coverage.
Widespread stories of coverage gaps could pose new political
problems for President Barack Obama, whose signature domestic policy
has already sparked a public uproar over the botched launch of the
website and the millions of cancellation notices sent out for
policies that do not comply with the law.
The administration said it would consider further extensions of the
enrollment deadlines if required by "extraordinary circumstances,"
having extended its Dec. 15 enrollment deadline for obtaining
benefits on Jan. 1 to midnight Dec. 23 (0500 GMT Dec.
24).
It also required insurers to enroll people who meet the deadline and
provide an initial premium payment by Dec. 31.
Officials led by U.S. Health and Human Services Secretary Kathleen
Sebelius also urged insurers to be flexible by allowing new
Obamacare customers to enroll for retroactive January 1 coverage, if
they wait until after New Year's Day to sign up or make only a
partial premium payment.
The list of what one official described as "mitigation strategies"
also asked insurers to maintain care for enrollees by treating
out-of-network physicians as in-network providers for acute episodes
and honoring refill prescriptions covered under previous plans
during January.
"The steps ... are important to help ensure that consumers
seamlessly transition from their current health plans into
marketplace coverage without experiencing any gaps," Mike Hash,
director of the Department of Health and Human Services Office of
Health Reform, told reporters on a conference call.
The Obama administration has acknowledged that 10 to 25 percent of
enrollments since October 1 have been transmitted inaccurately to
insurers or failed to show up at all.
Insurance industry officials have warned repeatedly that enrollment
errors could leave some people uninsured even after they have signed
up for coverage on HealthCare.gov, which serves consumers in 36
states.
"The big moment of trust is 12:01 a.m. on Jan. 1, when a mother
is standing in a pharmacy with a baby in her arms trying to get a
script filled," Aetna Inc Chief Executive Mark Bertolini told an
investors meeting on Thursday.
The main trade group representing health insurers said its members
would continue to do everything to protect consumers from potential
coverage disruptions cause by the problems with the government
website.
"With only weeks to go before coverage begins, continued changes to
the rules and guidance could exacerbate the challenges associated
with helping consumers through the enrollment process," said Karen
Ignagni, president of America's Health Insurance Plans.
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LAST-MINUTE FIXES
The pace of enrollment has accelerated in the run-up to the Dec.
23 deadline, though numbers remain well below projections that would
enable the administration to reach a goal of signing up 7 million
people in private insurance by the time enrollment ends on March 31.
But some welcome news arrived for Obama late on Thursday from
California, where state officials announced that their own Obamacare
marketplace saw an enrollment surge in the first week of December
that put the state on track to meet its target.
Republicans, who want to repeal and replace the law, are already
claiming it will create more uninsured people than it will enroll
next year.
"It's clear the administration knows Obamacare's problems are only
going to get worse, and patients will be the ones who suffer. What's
not clear is whether they understand the confusion and chaos they
continue to cause," said Rory Cooper, a spokesman for House or
Representatives Republican leader Eric Cantor.
The government and insurers this week began searching for problem
enrollment files in data on about 137,000 people who signed up for
coverage through HealthCare.gov in October and November. But because
the automated system intended for the job is not available yet, the
data search is relying on slower and more cumbersome manual methods.
The government also announced on Thursday a one-month extension
through January for a $5 billion federal insurance program that
currently provides coverage for almost 86,000 people with serious
health problems and said some states could follow suit on their own
programs.
"We don't want these folks to experience a coverage gap," said
Sebelius.
(Additional reporting by Caroline Humer and Sharon Begley in New
York; editing by Karey Van Hall and Tim Dobbyn)
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