Posted by AzBlueMeanie:
The White House this morning is rolling out a new Web site, HealthCare.gov,
which is designed to help health insurance consumers navigate the new
landscape when the new marketplace of exchanges starts on October 1st.
Since Arizona opted not to set up its own insurance exchange, the federal government will do it for us. The HealthCare.gov web site is the place for you to get information.
Sarah Kliff at Ezra Klein's Wonkblog writes today, Obamacare starts in 99 days. These 99 things need to happen before then:
Obamacare hit a pretty important milestone this weekend: The law is now
100 days away from its main provisions coming into effect. That means
the administration is pretty much in an all-out sprint to set up an
infrastructure by which millions of Americans will soon purchase
It will be orchestrating the largest expansion of private health
insurance in the country’s history. That means there’s a huge amount of
work to be done over the next few months. There are at least 99 things
that need to happen between now and October, and I’ve got a list to
prove it. Much of this is informed by the Government Accountability Office report
that came out last week, on the next big steps that need to happen on
health exchanges. Some are big, some are small but all are pretty
necessary to making the law work.
Here they are:
1. Health and Human Services must certify that 17 states will be able
to launch their own marketplaces. While these states currently have
conditional approval, none have the final go ahead to launch their
[List of states that are setting up their own insuance exchanges]
10. Exchange list interruption: The federal government likely needs to work on the fact that 42 percent of Americans don’t know that the health-care law is a law at all.
[List of more states that are setting up their own insuance exchanges]
19. There are another six states where the federal government will need to partner with the state to run a health exchange.
[List of states the federal government will partner with]
25. Exchange list interruption, continued: 43 percent
of Americans currently view the Affordable Care Act unfavorably. That’s
another challenge you can bet the administration is currently working
* * *
28. That leaves a whole bunch of states where the federal government
needs to step in, and build a health insurance exchange itself.
* * *
30. The federal government must launch an exchange in Arizona
[List of states where the federal government will build the insurance exchange]
56. HHS must work with each of these states to create a “mitigation
strategy,” according to a recent GAO report, that will “ensure that all
applicable exchange functions are operating in each state on Oct. 1,
57. If a state cannot handle the responsibilities of running a health
insurance exchange, the federal government will need to step in and
take over the task itself. This has already happened in Michigan and New
58. The federal government must sign contracts with at least two
multi-state plans, which will sell in at least two-thirds of the states
59. Massive call centers must open, big enough to handle 42 million calls by the end of this year.
60. All those call center agents will need to undergo training on the
Affordable Care Act. This is important: When Part D launched, about one-third of seniors got an inaccurate or incomplete answer from the new call center.
61. You can bet there will be lots of calls: As of November, the vast majority of Americans expected to be eligible for benefits had no idea that they would become available.
62. The Center for Medicare and Medicare Services must complete
testing of complex technology systems “to determine eligibility for
enrollment into a qualified health plan,” according to the GAO. This is
scheduled to finish in September.
63. The GAO says that the Medicare still needs to establish “business
service definitions” for the federal exchange. Those “describe the
activities, data elements, message formats and other technical
requirements that must be met.”
64. Another technical milestone to be met, again from the GAO:
Medicare needs to create “computer matching agreements, which establish
approval for data exchanges between various agencies systems”
65. And a third from the GAO! This one is about data use agreements
that still need to be made and “establish the legal and program
authority that governs the conditions, safeguards and procedures under
which federal or state agencies agree to use data.”
66. Medicare needs to evaluate hundreds of bids from health insurance plans to sell on the federally-facilitated exchange.
67. By August 26, Medicare plans to give insurance plans a preview of
the data that will display on the new health insurance exchanges.
68. By Sept. 15, the GAO says the agency expects “to finalize the
qualified health plan information and load it into the exchange
69. Health and Human Services must send out a first round of funding
for navigators, who are meant to help with exchange education and
outreach, by Aug. 15.
70. The agency then plans to hold a training program for the individuals who do receive navigator awards.
71. By Oct. 1, the navigator program must be up and running in the 34
states where the federal government is running the health insurance
72. The federal government has also promised to fund a navigator in every federally-qualified health center across the country.
73. Health insurance plans are, meanwhile, working up their own
outreach campaigns to lure customers to their new health exchange
74. By this summer, the federal government plans to translate its educational materials into 25 languages.
75. Medicare plans to create a complaint tracking system to monitor for problems in the health insurance exchange.
76. Forgot about the small business health exchange? Health and Human
Services hasn’t! By July, many states told the GAO that they plan to
finish certifying insurers that want to sell on this marketplace.
77. Of the 18 state-based small business exchanges, 10 plan to start call center training in July or August.
78. Seventeen of those 18 states plan to have their agents and brokers doing outreach work beginning this month.
79. “Most remaining eligibility and enrollment key activities [for
the SHOP exchange] were targeted to be completed by states by July 31,”
according to the GAO.
80. Medicare needs to finalize a single, streamlined application that
Americans can use to apply for both Medicaid and tax subsidies.
Speaking of Medicaid…
81. States must prepare to expand Medicaid to all people with an income lower than 133 percent of the federal poverty line.
82. States need to change how they count income for Medicaid, using
tax data rather than some of the asset tests and income disregards
sometimes used by the public insurance program.
83. Thirty-six Mississippi counties must wait to find out whether they’ll have any options available on their health exchange come October.
84. Mississippi also needs to figure out whether it will have a Medicaid program at all come October. Fun times!
85. The federal government must decide whether to approve Arkansas’s
Medicaid expansion plan, which would use Medicaid dollars to buy private
health insurance plans.
86. Companies need to begin monitoring how many hours their employees
work, to know who counts as “full time” and must receive health
87. The Internal Revenue Service needs to finalize a form where
individuals will report their source of health coverage (or,
alternatively, report no coverage and potentially pay a fine).
88. Enroll America, a nonprofit focused on maximizing enrollment
under the Affordable Care Act, must launch its outreach campaign focused
heavily in 10 states.
89. I’m surely forgetting one, right?
90. The administration will apparently continue talks with the National Football League and other professional sports leagues about partnering on outreach efforts.
91. I’m probably forgetting more than one, now that I think about it.
92. Maryland needs to finish approving the rates that health insurers have proposed for its health insurance exchange in 2014.
93. The Maryland Health Benefits Exchange also plans to launch its own outreach campaign in August.
94. The Washington Healthplanfinder needs to open its own call center on Sept. 1.
96. California needs to hire and train about 1,000 phone agents to work at three sites across the state.
97. Connect for Health Colorado appears to need to hire a health plan account manager in the not-so-distant future.
98. HHS will send out periodic updates on the marketplace’s progress to those who register on the new HealthCare.Gov.
99. Health and Human Services must implement the most important
health law provision of all: A baby otter for each health policy
*Not an actual provision of the law but rather a fantasy of this health policy reporter.