Sebelius Announces Three Affordable Care Act Deadline Extensions

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On Thursday, HHS Secretary Kathleen Sebelius on Thursday announced that her department is implementing a trio of Affordable Care Act deadline extensions intended to ease the transition to coverage in the law's new insurance marketplaces in 2014, Modern Healthcare reports (Demko, Modern Healthcare, 12/12).

Sebelius said that changes were prompted by the various technical issues that plagued the online marketplaces -- particularly the federal health insurance exchange -- when they were launched in October, which caused problems and delays for consumers when they tried to enroll in health plans. As a result, she said many consumers will need more time to select and pay for the new coverage (Pear, New York Times, 12/12).

Sebelius said HHS has:

  • Officially asked insurers to honor the new Dec. 23 deadline for coverage that begins on Jan. 1 (Kliff, "Wonkblog," Washington Post, 12/12);
  • Urged insurers to give consumers more time -- until Dec. 31 -- to make their payments for coverage that begins Jan. 1 and asked them to accept late or partial payments for coverage (New York Times; 12/12); and
  • Extended by one month -- through the end of January 2014 -- the federal Pre-Existing Condition Insurance Plan, which has been providing coverage to about 100,000 U.S. residents with severe health conditions who were unable to purchase private coverage prior to the ACA (Galewitz, Kaiser Health News, 12/12).

An HHS fact sheet said the department "will consider moving [the Dec. 23] deadline to a later date should exceptional circumstances pose barrier to consumers enrolling on or before" that date (Young, CQ Roll Call, 12/12).

In addition, Sebelius announced that:

  • HHS has asked insurers to provide "retroactive coverage for people who sign up after Jan. 1," meaning that if a consumer signs up for coverage on Jan. 5, his or her coverage still would be effective on Jan. 1; and
  • Some consumers who experienced unique problems with signing up for coverage in the federal or state exchanges would be eligible for a "special enrollment period," which will provide them with extra time to complete their enrollment (New York Times, 12/12).

Officials in the Obama administration said that they are encouraging insurers to make additional voluntary accommodations for new enrollees, such as:

  • Continuing coverage for patients' preferred physicians, even if they are out-of-network under their new coverage plan (Modern Healthcare, 12/12); and
  • Providing temporary coverage for prescription drugs beyond Jan. 1, even if the drugs are not on the plans' list of approved medications (New York Times, 12/12).

Reactions

In a statement, America's Health Insurance Plans CEO and President Karen Ignagni criticized the new changes, saying that "continued changes to the rules and guidance could exacerbate the challenges associated with helping consumers through the enrollment process." She added, "Health plans will continue to do everything they can to protect consumers from potential coverage disruptions caused by the ongoing technical problems with HealthCare.gov" (CQ Roll Call, 12/12).

Some Republican leaders in Congress also criticized HHS' move. Rory Cooper, a spokesperson for House Majority Leader Eric Cantor (R-Va.), said, "It's clear that the administration knows Obamacare's problems are only going to get worse, and patients will be the ones who suffer." He added, "What's not clear is whether they understand the confusion and chaos they continue to cause" (New York Times, 12/12).


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