Insurers fear “small” enrollment period changes

Insurers, regulators and exchange managers developed the open enrollment period system for individual major medical coverage to keep consumers from waiting until they get sick to pay for insurance. The open enrollment period for all PPACA-compliant major medical coverage started Oct. 1, 2013. The open enrollment period and enrollment period extensions sputtered out throughout the country by May 30.

Consumers who want to buy coverage today must show that they have undergone a major life event, such as the birth of a child, or that they qualify for a special enrollment period (SEP) for some other reason. Covered California has been thinking about letting consumers enroll in QHPs outside of the open enrollment period for 90 days while waiting for the exchange to verify whether they are eligible for a SEP.

Proposal supporters argue that consumers need help with keep bureaucracy and paperwork problems from interfering with access to health care. Insurers believe that letting consumers enroll in QHPs without going through eligibility determinations first will hurt the integrity of the open enrollment period, Chapman writes.

The open enrollment period “is one of the few ways that health plans have to control costs and ensure that coverage is affordable,” Chapman says.