Time flies.

It’s hard to know how the new Patient Protection and Affordable Care Act (PPACA) open enrollment calendar system is really going to work, given how mysterious pretty much all PPACA programs are.

It seems as if the open enrollment period for individual “qualified health plan” (QHP) — and the extra, bonus, enrollment extension period — have, apparently, ended everywhere in the country except for Nevada.

(Contest: If you know of any place but Nevada that still has some kind of relatively open enrollment period for individual QHP coverage going on: Post about that in the comments, and I’ll Plus 1 your insightful post.)

On the one hand: The PPACA program designers came up with the system to try to prevent antiselection, by limiting people to buying major medical coverage at certain times of the year, to scare consumers away from waiting until they get sick to buy coverage.

On the other hand: What a dumb system. It’s now much easier to buy the kinds of supplemental health insurance products that the PPACA drafters really don’t like very much than it is to buy major medical coverage.

On the third hand: Maybe the joke here is that it just seems harder to buy major medical coverage, because you need to qualify for a “special enrollment period” (SEP) to apply for coverage. But, from my perspective, when I look at the list of life events that could help me get a SEP, it seems as if the list of reasons includes just about every reason why I’d ever consider buying major medical coverage, such as loss of a job or divorce. How many uninsured people really just wake up in July and say, “Gee, I ought to have major medical insurance!” Maybe not a lot.

On the fourth hand, it’s hard to say, but, love PPACA or hate it: It could be that the “end of the open enrollment period” is a great marketing gimmick.

Slam the door in consumers’ faces. Say, “You’re not good enough to have our product. Go away!” Then leave a sheet of paper with the secret knock consumers need to get through the door lying on the ground in front of the door. Maybe consumers who are incensed by the idea of being shut out will suddenly do everything possible (including looking at pieces of paper lying in the ground) to crack the door.

Maybe (again, whatever folks actually think about PPACA and the exchange program) the long-term care insurance (LTCI) community could learn from that approach.

Instead of welcoming consumers, and courting them, and aggressively urging them to buy LTCI coverage, maybe the insurers could have an open enrollment period that starts when consumers are, say, 25, and ends when the consumers are 30. Then slam a door. Make consumers work hard to find the sheet of paper describing the secret knock. 

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