Later this month, I’ll have the opportunity to hear about changes being made to my benefit plan. For the past couple of years, my employer has been holding “benefit and wellness fairs,” which afford us the opportunity to ask questions of various vendors about pending changes to our coverage. It’s actually a great chance to learn firsthand about what will be different in 2015 and how much it is going to cost me.
While those of us covered by an employer-sponsored plan are finishing up our paperwork, millions of other Americans will be trying their darndest to navigate the health insurance marketplaces, where open enrollment stretches from Nov. 15 to Feb. 15. Of course, we all remember last year’s disastrous launch. With computer glitches long since resolved, I’m guessing that open enrollment will go much smoother this time around.
Similar to my workplace fairs, HHS’ marketplace consumer assistance program is designed to help consumers understand what they’re getting themselves into. All insurance marketplaces are required by the Affordable Care Act to have an assister program. Between October 2013 and March 2014, roughly 28,000 FTEs and volunteers working in 4,400 assister programs helped consumers to navigate their way through the complicated morass of the exchanges, according to a July 15 Kaiser Family Foundation Study.
As with nearly everything ACA-related, the assister program has been a mixed bag, as highlighted by a KFF and Robert Wood Johnson Foundation report issued earlier this week. In the summer, the groups gathered with 80 leaders from assistance programs to get a sense of how things went in Year One. The report offers some interesting findings:
- Assisters need to build relationships with consumers before the enrollment process begins.
- Keeping pace with regulatory changes and the issuance of new guidelines was challenging.
- Many marketplaces lacked adequate tools to help assisters compare plans and find the best match for the consumer.
- Programs experienced a boomerang effect, with newly insured people returning with questions about everything from understanding their coverage to figuring out how to pay their premium.
These challenges aren’t insignificant. In early September, Health & Human Services awarded $60 million to 90 navigator programs. For many people entering the marketplaces, assisters and navigators are the first formal contact they will have with our revamped health care system. As Mom always told us, first impressions matter.